Current Problems In Cardiology[JOURNAL]
Sun
200 papers
The future of cardiology: Integrating single-cell transcriptomics with multi-omics for enhanced cardiac disease insights.
Tang Z, Alrumaihi F, Alwanian WM … +7 more , Alharbi HO, Allemailem KS, Alissa M, Alasmari O, Almousa S, Ainsworth T, Chen X
Curr Probl Cardiol · 2025 Apr · PMID 39894239 · Publisher ↗
Recent advancements in single-cell transcriptome sequencing (scRNA-seq) have revolutionized our understanding of cellular heterogeneity in cardiovascular diseases, enabling the identification of novel therapeutic targets...
Recent advancements in single-cell transcriptome sequencing (scRNA-seq) have revolutionized our understanding of cellular heterogeneity in cardiovascular diseases, enabling the identification of novel therapeutic targets. This technology allows for high-resolution analysis of gene expression at the single-cell level, revealing the complex dynamics of human heart cell development and the diverse roles of cardiac cell types in health and disease. Despite its transformative potential, current applications of scRNA-seq face limitations, including challenges in data integration and the need for comprehensive multi-omic approaches to fully elucidate the mechanisms underlying cardiovascular pathologies. This review highlights the significant insights gained from scRNA-seq studies in the mammalian heart, emphasizing the importance of integrating spatial transcriptomics and other omics technologies to enhance our understanding of cardiac biology. Furthermore, it addresses the critical research gaps in the field, particularly in the context of personalized medicine and the need for improved methodologies to analyze rare cell populations. By exploring these challenges and opportunities, this review aims to pave the way for innovative diagnostic and therapeutic strategies that can ultimately improve outcomes for patients with cardiovascular diseases.
Cardiac transplantation in muscular dystrophies: A case series.
Bergier MG, Blanco R, Lillo E … +2 more , Posatini R, Belziti CA
Curr Probl Cardiol · 2025 Apr · PMID 39892684 · Publisher ↗
Muscular dystrophies can involve cardiac complications, including dilated cardiomyopathy, arrhythmias, and conduction system disorders. In cases of terminal heart failure, cardiac transplantation may be considered a viab...
Muscular dystrophies can involve cardiac complications, including dilated cardiomyopathy, arrhythmias, and conduction system disorders. In cases of terminal heart failure, cardiac transplantation may be considered a viable option; however, its feasibility in this population has been questioned for many years. This case series describes the preoperative characteristics and postoperative outcomes of five patients with muscular dystrophy and dilated cardiomyopathy who underwent cardiac transplantation at a tertiary care center in Latin America between 2018 and 2024. All patients were male, with a mean age of 38.4 ± 11.5 years at transplantation. Genetic variants were confirmed in all cases. Although two patients experienced postoperative respiratory and swallowing complications, survival was 100 %, with a median follow-up of 16 months and good functional capacity. Cardiac transplantation is a valid option for patients with muscular dystrophies and dilated cardiomyopathy, emphasizing the importance of functional evaluation and a multidisciplinary approach to optimize outcomes.
Sleep: Its nature and mechanism in Avicenna's medicine and psychology.
Aghaei ZSPS, Ramin F
Curr Probl Cardiol · 2025 Apr · PMID 39892683 · Publisher ↗
Sleep is a fundamental necessity for humans and other living beings. Throughout history, many thinkers have sought to understand its complexities. Avicenna, in his works, elucidates the nature and mechanism of sleep from...
Sleep is a fundamental necessity for humans and other living beings. Throughout history, many thinkers have sought to understand its complexities. Avicenna, in his works, elucidates the nature and mechanism of sleep from two angles: "sleeping," as an essential process for sentient beings, and "dreams," which reflect the effects of sleep on human life and health. This article explores sleep through Avicenna's lens, examining its philosophical, psychological, and medical foundations. It begins with a definition of sleep, followed by an analysis of its causes, manifestations, and types, including natural, unnatural, and artificial. The findings indicate that Avicenna was a pioneer in studying altered states of perception within the imagination, showcasing his understanding of hypnotic sleep and its therapeutic applications for disorders like melancholy.
Utility of lung ultrasound to identify patients at risk of rehospitalization for acute decompensated heart failure.
Iroulart JM, Garagoli F, Bergier MG … +5 more , Decotto S, Villar GF, Belziti C, Rossi E, Pizarro R
Curr Probl Cardiol · 2025 Apr · PMID 39890047 · Publisher ↗
INTRODUCTION: Residual congestion at hospital discharge predicts adverse outcomes in acute decompensated heart failure (ADHF). Lung ultrasound (LUS) is a reliable tool for assessing pulmonary congestion. This study aims...
INTRODUCTION: Residual congestion at hospital discharge predicts adverse outcomes in acute decompensated heart failure (ADHF). Lung ultrasound (LUS) is a reliable tool for assessing pulmonary congestion. This study aims to evaluate a simplified 4-zone LUS method for identifying heart failure patients at risk after discharge. METHODS: This prospective study included adults hospitalized for ADHF without treatable secondary causes. We employed a 4-zone LUS method to quantify B-lines. The primary endpoint was a composite of mortality or rehospitalization within 180 days. We used univariate and multivariate Cox models to evaluate the prognostic value of B-lines. A receiver operating characteristic (ROC) curve identified the optimal B-lines threshold. RESULTS: We included 155 patients (median age: 81 years [IQR 75-85]; 52.9 % male). After the follow-up period, 53 (34.2 %) patients met the primary endpoint. The ROC curve for the number of B-lines at discharge showed an AUC of 0.8, with 7 B-lines identified as the optimal cutoff (sensitivity: 70 %, specificity: 82 %). In univariate analysis, the global B-line count at discharge (HR: 1.33, 95 % CI 1.22-1.45) was significantly associated with the primary endpoint. Using a cutoff of ≥7 B-lines, the association was stronger (HR: 6.92, 95 % CI 3.80-12.60). After multivariable adjustment, ≥7 B-lines at discharge remained significant (HR: 4.41, 95 % CI 1.98-9.81). CONCLUSION: In our population, the detection of 7 or more B-lines at discharge serves as a reliable marker for identifying patients at risk of mortality or rehospitalization within 180 days.
Real-world efficacy of tirzepatide in patients with heart failure without diabetes.
Augusto SN, Kaelber D, Tang WHW
Curr Probl Cardiol · 2025 Apr · PMID 39890046 · Full text
BACKGROUND: Tirzepatide, a dual agonist of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors, has shown significant cardiovascular benefits in clinical trials. This study in...
BACKGROUND: Tirzepatide, a dual agonist of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors, has shown significant cardiovascular benefits in clinical trials. This study investigates the real-world impact of tirzepatide on heart failure (HF) outcomes, leveraging data from the TriNetX platform. METHODS: Using data from January 1, 2013, to December 01, 2024, we conducted a propensity-matched analysis of two cohorts of patients with HF without diabetes, where the only difference was the use of tirzepatide. The primary outcome was the incidence of acute heart failure (acute HF), with secondary outcomes including major adverse cardiovascular events (MACE), chronic kidney disease (CKD), stroke, and coronary arterial disease (CAD). RESULTS: After propensity-matching, 897 patients were compared between the two cohorts in a 4-year follow-up, showing that untreated patients were at higher risk of incident acute HF (HR: 3.12, 95 %CI = 2.240-4.349, log-rank p < 0.001) and MACE (HR: 3.57, 95 %CI = 2.32-5.48, log-rank p < 0.001). Stroke (HR: 2.796, 95 %CI = 1.353-5.776, log-rank p < 0.01), CKD (HR: 1.48, 95 %CI: 1.08-2.03, log-rank p = 0.015), and CAD (HR: 1.474, 95 %CI,1.169-1.859, log-rank p = 0.001) outcomes also favored the treatment cohort. CONCLUSION: Tirzepatide presents a promising therapeutic option for managing heart failure, with significant metabolic and cardiovascular benefits. These real-world findings reinforce its potential role as a transformative treatment in improving clinical outcomes and quality of life for patients with HF without diabetes.
Atrioventricular block and conduction disorders induced by ICIs: Individual patient data systematic review: "Conduction disorders induced by ICIs".
Pascalis L, Fazzini L, Dessalvi CC
Curr Probl Cardiol · 2025 Apr · PMID 39890045 · Publisher ↗
Immune checkpoint inhibitors (ICIs) are monoclonal antibodies that enhance T cell-mediated anti-tumor responses but may induce cardiotoxicity, including conduction disorders and atrioventricular blocks (AVB). A systemati...
Immune checkpoint inhibitors (ICIs) are monoclonal antibodies that enhance T cell-mediated anti-tumor responses but may induce cardiotoxicity, including conduction disorders and atrioventricular blocks (AVB). A systematic review of 30 case reports involving cancer patients treated with ICIs was conducted. The majority of affected patients were in advanced stages of lung and kidney/urothelial cancers, predominantly male, and typically developed AVB within three weeks of therapy, often accompanied by myocarditis. Complete AVB was the most frequently observed disorder, necessitating interruption of therapy and temporary pacing. Less than half of the cases were reversible, and in-hospital mortality was significant. Further research is needed.
"Artificial Bachmann's Bundle", employing carbon nanotube fibers in the prevention/management of atrial fibrillation.
Madias JE
Curr Probl Cardiol · 2025 Apr · PMID 39890044 · Publisher ↗
The present communication constitutes a proposal of attempting to restore interatrial electrical conduction in patients with interatrial block and malfunctioning Bachman's bundle, or other interatrial conduction pathways...
The present communication constitutes a proposal of attempting to restore interatrial electrical conduction in patients with interatrial block and malfunctioning Bachman's bundle, or other interatrial conduction pathways, employing carbon nanotube fibers (i.e., an "artificial Bachman's bundle"), in order to prevent emergence of atrial fibrillation, and by extension even possibly ameliorate or effectively treat paroxysmal/persistent/permanent atrial fibrillation.
Practical guidance for management of atrial fibrillation in sports cardiology.
Palermi A, Molinari LV, Ricci F … +2 more , Gallina S, Renda G
Curr Probl Cardiol · 2025 Apr · PMID 39890043 · Publisher ↗
IMPORTANCE: Atrial fibrillation (AF), the most prevalent sustained arrhythmia, portends higher risk of cardiovascular morbidity and mortality, and is associated with quantifiable impairment in quality of life. While phys...
IMPORTANCE: Atrial fibrillation (AF), the most prevalent sustained arrhythmia, portends higher risk of cardiovascular morbidity and mortality, and is associated with quantifiable impairment in quality of life. While physical activity is widely recognized for its cardiovascular benefits, recent evidence challenges its role in the development of AF. OBSERVATIONS: Emerging data suggest a U-shaped relationship between physical activity and AF risk. Mild to moderate exercise appears protective, whereas prolonged, high-intensity activity is associated with an increased risk, possibly driven by cardiac remodeling, autonomic alterations, and atrial substrate changes typical of the so-called athlete's heart. This relationship is further modulated by other factors, including genetic predisposition, acquired cardiac conditions, and stimulant use. With the growing participation of aging populations in sports, the clinical management of AF in athletes presents unique challenges. Pharmacological strategies for rhythm and rate control may conflict with performance goals, and the use of anticoagulants must be carefully balanced against the risk of traumatic bleeding in contact sports. Recent evidence supports strategies such as short-term anticoagulant withdrawal to mitigate hemorrhagic risk while maintaining thromboembolic protection. A personalized approach, incorporating shared decision-making, is essential, particularly for elite athletes. CONCLUSIONS AND RELEVANCE: While regular physical activity generally confers cardiovascular benefits, prolonged intense exercise bouts may paradoxically increase the risk of AF. The evaluation and management of AF in athletes require a tailored, multidisciplinary approach that accounts for the distinct needs of this population.
Genotype-phenotype correlations in hypertrophic cardiomyopathy: Insights from an HCM Center of Excellence.
Ashraf M, Jan MF, Jahangir A … +5 more , Kroboth S, Abood Z, Walczak S, Sanders H, Tajik AJ
Curr Probl Cardiol · 2025 Apr · PMID 39890042 · Publisher ↗
BACKGROUND: Owing to the recognition of previously unknown pathogenic gene variants and reclassification of longer-known variants, gene distribution in patients with hypertrophic cardiomyopathy (HCM) is ever-changing. Co...
BACKGROUND: Owing to the recognition of previously unknown pathogenic gene variants and reclassification of longer-known variants, gene distribution in patients with hypertrophic cardiomyopathy (HCM) is ever-changing. Conflicting data make the role of genotype in risk stratification unclear. METHODS: We evaluated genotype distribution and genotype-phenotype correlations in all adult patients with HCM seen at our HCM Center of Excellence from March 31, 2010, to April 30, 2023. We also evaluated a composite outcome, including all-cause mortality, stroke, implantable cardioverter-defibrillator placement, heart failure hospitalization, left ventricular assist device implantation, heart transplantation, septal myectomy, and alcohol septal ablation, based on genotype status. All-cause mortality was separately analyzed. RESULTS: Of 827 patients with HCM, genotyping was completed in 754 (91.2 %). We identified 202 (27 %) genotype-positive (Gen-P), 163 (22 %) variant of unknown significance (VUS), and 389 (51 %) genotype-negative (Gen-N) patients. Mean ages were 47, 57, and 58 years, respectively. The most common gene implicated was MYBPC3 (63 %). More patients were on optimal medical treatment after following up with our HCM center. Electrocardiographic, Holter, echocardiographic, and cardiac magnetic resonance imaging characteristics differed based on genotype status. The composite outcome was worse in Gen-P than Gen-N (HR 1.84, p<0.001). Although analysis of all-cause mortality showed survival was different for Gen-P and VUS patients than for Gen-N patients, this difference was not statistically significant. CONCLUSION: MYBPC3 was the most common gene implicated. Outcomes were worse in Gen-P patients. Centers of Excellence play an important role in the optimal medical management of patients with HCM.
Transhepatic venous access for catheter ablation of right and left side atrial arrhythmias in adults: challenges and outcomes.
Adams CD, Tapias CA, Rodriguez DA … +4 more , Cabrera JS, Hernandez BM, Bautista WF, Saenz LC
Curr Probl Cardiol · 2025 Apr · PMID 39863006 · Publisher ↗
INTRODUCTION: Electrophysiologic (EP) procedures are typically performed via the femoral venous system, but in some patients, the inferior vena cava (IVC) is unavailable. The hepatic vein has emerged as a viable alternat...
INTRODUCTION: Electrophysiologic (EP) procedures are typically performed via the femoral venous system, but in some patients, the inferior vena cava (IVC) is unavailable. The hepatic vein has emerged as a viable alternative to femoral access, providing an inferior route that accommodates large sheaths required for better catheter manipulation. Although the percutaneous transhepatic approach has been used successfully in the pediatric population, its use in adults is scarce, with a complication rate of approximately 5 %. METHODS AND RESULTS: Three patients with limited venous access were referred for ablation between 2018 and 2021. The percutaneous transhepatic access approach provided good support for the EP study, electro-anatomical mapping, and effective radiofrequency ablation of right and left-side arrhythmias. No significant complications were documented, and all patients were discharged within 48 h of the procedure. At follow-up, all patients had excellent arrhythmia control without significant adverse events. CONCLUSION: Percutaneous transhepatic access is a feasible and safe alternative to femoral venous access for EP procedures in adult patients with limited venous access.
Emotions & Heart:Exploring the Impact of Negative Emotions on Cardiovascular Health.
Malik S, Ali ZS, Al-Rawi R … +6 more , Lavercombe W, Gupta S, Zhou Z, Farina JM, Marcotte L, Baranchuk A
Curr Probl Cardiol · 2025 Mar · PMID 39848354 · Publisher ↗
Negative emotions can have a significant impact on individuals, which then influences their cardiovascular system. However, the underlying pathophysiological mechanisms and clinical implications of this association remai...
Negative emotions can have a significant impact on individuals, which then influences their cardiovascular system. However, the underlying pathophysiological mechanisms and clinical implications of this association remain inadequately defined. A narrative review of pertinent literature was conducted to examine the pathophysiology, clinical manifestations, and treatment related to the interplay between emotions and conditions such as takotsubo cardiomyopathy, atherosclerosis, acute plaque rupture, and cardiac arrhythmias. Negative emotions can instigate a chronic stress response, which in turn heightens sympathetic nervous system activity and increases vulnerability to cardiovascular diseases. This intricate relationship between emotional states and cardiovascular health underscores the necessity for targeted lifestyle interventions and clinical strategies aimed at mitigating the adverse effects of negative emotions.
The diagnosis and treatment of asymptomatic and symptomatic patients with carotid artery stenosis.
Henning RJ, Hoh BL
Curr Probl Cardiol · 2025 Jun · PMID 39832540 · Publisher ↗
Carotid artery atherosclerotic stenosis is an important annual cause of stroke in the United States. Moreover, the incidence of carotid artery stenosis is significantly increasing due to the widespread popularity of high...
Carotid artery atherosclerotic stenosis is an important annual cause of stroke in the United States. Moreover, the incidence of carotid artery stenosis is significantly increasing due to the widespread popularity of high fat and high salt diets, sedentary lifestyles, and the increasing age of the population. Of major importance to cardiovascular specialists is the fact that individuals with atherosclerotic carotid artery stenosis can have a prevalence of atherosclerotic coronary artery disease as high as 50 to 75%. Vascular screening for carotid artery stenosis with Doppler ultrasound should be considered for all symptomatic patients with possible carotid stenosis and also considered for asymptomatic patients with (1) symptomatic peripheral arterial disease, coronary artery disease, or atherosclerotic aortic aneurysm or, (2) multiple atherosclerotic risk factors. Carotid artery atherosclerotic plaques that are at high risk for rupture and thrombosis or cerebral embolization are characterized by large lipid cores, intraplaque hemorrhage, thin fibrous caps less than 165 μms that are infiltrated by macrophages and T cells or have surface ulcer(s) or fissures. Carotid artery plaque rupture with cerebral embolism can cause a stroke, transient ischemic attacks (TIA), or ipsilateral blindness (amaurosis fugax). Medical treatment based on the recommendations of the American and European Societies for Vascular Surgery and the American Heart Association for symptomatic patients with carotid stenosis and also asymptomatic patients with high risk carotid stenosis plaques include antiplatelet drugs, antihypertensive drugs for hypertension control and lipid lowering drugs. Management strategies and decisions about carotid revascularization in asymptomatic patients with high risk carotid stenosis should involve a multidisciplinary team and shared decision-making is recommended. The 30 day and five to 10 year outcomes in asymptomatic carotid stenosis patients who have undergone carotid endarterectomy, carotid stenting and/or optimal medical therapy are summarized from the Veterans Administration Cooperative Study, the Asymptomatic Carotid Atherosclerosis Study and the Asymptomatic Carotid Surgery Trials. The current Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial (CREST-2) should help to resolve the debate regarding carotid artery revascularization versus primary medical treatment in asymptomatic patients with >70% carotid artery stenosis. Symptomatic patients who present within 4.5 hours of stroke onset require evaluation for acute intravenous pharmacologic thrombolysis and patients who present with large vessel occlusion within 24 hours of symptom onset should be considered for mechanical thrombectomy to reduce the neurologic deficit. Patients with carotid artery stenosis who present with a history of cerebral infarct in the preceding six months due to cerebral embolism require medical treatment and evaluation by a multidisciplinary team for carotid revascularization in order to prevent future strokes or TIAs. The outcomes of the North American Symptomatic Carotid Endarterectomy Trial, Carotid Revascularization Endarterectomy Versus Stent Trial, Stent-Supported Percutaneous Angioplasty of the Carotid Artery vs. Endarterectomy Trial, and the Safety and Efficacy Study for Reverse Flow Used during Carotid Artery Stenting Procedure trials for symptomatic patients with carotid stenosis are reviewed. A synopsis of treatment guidelines for symptomatic and asymptomatic carotid stenosis patients from the American and European Societies of Vascular Surgery and the American Heart Association/American Stroke Association are presented. Each patient with carotid artery stenosis must be carefully evaluated to determine the best treatment based on the clinical presentation, the imaging and laboratory diagnostic information, the treatment guidelines, and the patient needs and preferences as well as the patient's social and cultural factors.
The Role OF 3D echocardiography in prediction of pulmonary vascular resistance and its reversibility in simple congenital heart disease with secondary pulmonary hypertension.
Awad MR, Eweda II, Ismail EM … +1 more , Abdeltawab AA
Curr Probl Cardiol · 2025 Mar · PMID 39828112 · Publisher ↗
BACKGROUND: Pulmonary hypertension is a progressive and often fatal disease that frequently presents with the non-specific symptom of dyspnea on exertion. AIM: To determine non-Invasive Predictors of Pulmonary vascular r...
BACKGROUND: Pulmonary hypertension is a progressive and often fatal disease that frequently presents with the non-specific symptom of dyspnea on exertion. AIM: To determine non-Invasive Predictors of Pulmonary vascular resistance severity and reversibility in simple Congenital Heart Disease Patients Using 3D Echocardiography. PATIENTS AND METHODS: This was a Prospective cohort study conducted on 40 patients selected from attendees of Cardiology clinics of Ain Shams University Hospitals over a period of 2 years. RESULTS: There was a statistically significant positive correlation between PVR and its reversibility and right ventricular parameters (EDV/ESV/SVI), tricuspid valvular parameters (Coaptation height/Tenting volume/Annulus perimeter/Major axis/Minor axis) measured by 3D echocardiography (P < 0.05). On the other hand, no statistically significant correlation was found between PVR or its reversibility and ejection fraction, and annulus area (P < 0.05). All echocardiographic parameters are either excellent or good predictors for reversibility of PVR except for EF, FAC, and S'. CONCLUSION: We conclude that EDV, ESV, SVI, CoH, tenting volume, and annulus perimeter were the most important variables to predict the PVR and found that all echocardiographic parameters were either excellent or good predictors for reversibility of PVR except for EF, FAC, and S'.
Comparative lipidomic profiling in adolescents with obesity and adolescents with type 1 diabetes.
García-Hermoso A, Huerta-Uribe N, Izquierdo M … +3 more , González-Ruíz K, Correa-Bautista JE, Ramírez-Vélez R
Curr Probl Cardiol · 2025 Mar · PMID 39828111 · Publisher ↗
OBJECTIVE: Both adolescents with obesity and those with type 1 diabetes (T1D) exhibit alterations in lipid profiles, but direct comparisons are limited. Comparing lipidomic profiles between obese individuals and those wi...
OBJECTIVE: Both adolescents with obesity and those with type 1 diabetes (T1D) exhibit alterations in lipid profiles, but direct comparisons are limited. Comparing lipidomic profiles between obese individuals and those with T1D is crucial for identifying specific metabolic markers, informing tailored interventions, and advancing precision medicine strategies for these distinct populations. The aim of the study was to compare lipidomic profiles between adolescents with obesity and those with T1D, and to analyze associations between metabolites and clinical parameters. METHODS: We included 156 adolescents aged 11-18 years (59.6% girls) from the HEPAFIT (n=114, obesity) and Diactive-1 Cohort (n=42, T1D) studies. Clinical measures included anthropometrics, body composition, lipids, liver enzymes, glucose, and HbA1c. Lipidomic analysis of 277 serum/plasma metabolites used UHPLC-MS. RESULTS: Distinct lipid profiles were seen, with higher diglycerides, triglycerides, and certain phosphatidylinositols in the obesity group, while phosphatidylcholines, phosphatidylethanolamines, cholesterol esters, sphingomyelins, and ceramides were elevated in T1D. Triglycerides acyl chain lengths and saturation levels also varied. Multivariate analysis identified seven metabolites -PC(O-18:1/18:1), PC(O-18:1/22:4), PE(O-16:0/18:1), PE(18:2e/22:6), PC(40:1), PC(O-22:1/20:4), and PE(P-18:0/18:1)- significantly associated with clinical parameters. CONCLUSIONS: Distinct lipid profiles were observed among adolescents with obesity and T1D in the study, emphasizing the importance of understanding specific metabolite associations with clinical parameters for more precise health management.
National trends in heart failure admissions in Peru: Insights on regional and demographic disparities from 2018 to 2023.
Diaz-Arocutipa C, Salguero-Bodes R, Juárez V … +6 more , Martín-Asenjo R, Valenzuela-Rodriguez G, Torres-Valencia J, Ríos-Navarro P, Pariona M, Vicent L
Curr Probl Cardiol · 2025 Mar · PMID 39828110 · Publisher ↗
BACKGROUND: Heart failure (HF) represents a significant public health challenge, particularly in low- and middle-income countries, where demographic shifts and healthcare disparities influence disease patterns. This stud...
BACKGROUND: Heart failure (HF) represents a significant public health challenge, particularly in low- and middle-income countries, where demographic shifts and healthcare disparities influence disease patterns. This study aimed to analyze trends in HF admissions across Peru from 2018 to 2023. METHODS: We conducted a secondary data analysis of emergency department morbidity records of patients aged ≥20 years registered in the National Superintendence of Health (SUSALUD) database. HF admissions were identified using ICD-10 codes. Age-adjusted standardized HF admission rates per 100,000 persons were estimated using the direct method. Annual percentage changes with their 95% confidence intervals (CI) were estimated using Poisson regression models. RESULTS: In total, 38,931 HF admissions were recorded, with the majority occurring in patients aged ≥60 years (69.2%), and 51.2% of cases were men. HF admissions showed an overall annual growth rate of 2.78% (95% CI 0.95% - 4.65%), 2.92% (95% CI 1.13% - 4.74%) for men, and 2.57% (95% CI 0.45% - 4.73%) for women. Regional disparities were evident, with the highest rates observed in the Amazon region. HF admissions declined during 2020, followed by a rebound in subsequent years. CONCLUSION: HF admissions in Peru increased from 2018 to 2023, with notable disparities by sex and region. These findings underscore the need for targeted interventions to address regional and demographic variations in HF burden.
Cardiac surgery outcomes: The efficacy of dexmedetomidine in reducing postoperative delirium - A bibliometric study.
Yabo W, Dongxu L, Xiao L … +1 more , Qi A
Curr Probl Cardiol · 2025 Mar · PMID 39828109 · Publisher ↗
Postoperative delirium (POD) is a prevalent complication following cardiac surgery, characterized by acute brain dysfunction observed in critically ill patients. Despite the significant impact of POD, there is currently...
Postoperative delirium (POD) is a prevalent complication following cardiac surgery, characterized by acute brain dysfunction observed in critically ill patients. Despite the significant impact of POD, there is currently no established treatment. Recent research has suggested that modulation of cholinergic neurotransmission and α2-adrenergic receptors may offer a therapeutic strategy for managing delirium during critical illness. This study employs bibliometric analysis to examine the emerging evidence on the role of dexmedetomidine, an α2-receptor agonist drug, in the prevention and treatment of POD. A systematic bibliometric analysis was conducted to identify and evaluate the literature on the use of dexmedetomidine in relation to POD. The study period spanned from 2006 to 2022, and the search was conducted in the Web of Science (WOS) database, focusing on relevant references. The analysis included the examination of the most frequent keywords, research trends, and frontiers to provide a comprehensive overview of the field. The bibliometric analysis revealed 160 research papers on the topic, indicating a significant increase in research output over the past decades. The field distribution, knowledge structure, and research topic evolution were identified as key areas of exploration. The analysis also highlighted the emergence of new topics and trends in the study of POD and its management. This bibliometric analysis provides a robust framework for understanding the current state of research on dexmedetomidine's efficacy in managing POD. It highlights the need for continued investigation and underscores the potential of this pharmacological approach to improve patient outcomes following cardiac surgery.
Sacubitril-valsartan in Cancer therapy-induced heart failure: A systematic review and meta-analysis of functional and hemodynamic parameters.
Hüntermann R, Fischer-Bacca CO, Alves MF … +7 more , Livramento Junior VA, Alexandrino FB, Sato MY, Gomes RF, Rocha FR, Gambetta MV, Melo ES
Curr Probl Cardiol · 2025 May · PMID 39828108 · Publisher ↗
BACKGROUND: Cancer therapy-induced cardiotoxicity (CTRCD), in the form of heart failure with reduced ejection fraction (HFrEF), is being increasingly recognized. However, the potential benefits of sacubitril/valsartan (S...
BACKGROUND: Cancer therapy-induced cardiotoxicity (CTRCD), in the form of heart failure with reduced ejection fraction (HFrEF), is being increasingly recognized. However, the potential benefits of sacubitril/valsartan (S/V) in managing HFrEF secondary to CTRCD remain unclear. OBJECTIVE: We performed a systematic review and meta-analysis to assess the effectiveness of S/V in preventing cardiotoxicity. METHODS: We searched PubMed, Embase, and Cochrane databases for studies evaluating S/V in patients with HFrEF due to CTRCD and reporting the following outcomes: (1) NYHA class; (2) NT-ProBNP and (3) echocardiographic measurements, specifically left ventricular ejection fraction (LVEF), global longitudinal strain (GLS) and E/e' ratio. Statistical analyses were performed using RStudio software. Heterogeneity was assessed using I² statistics. RESULTS: We included 257 patients from six studies. All patients received S/V. The mean patient age was 63 ± 8 years, and 85 % of patients had breast cancer. The mean LVEF was 34±7 % at baseline. S/V significantly improved NYHA class compared to baseline (MD -0.7; 95 % CI -1.2 to -0.3; p < 0.01), NT-proBNP (MD -985.1 pg/mL; 95 % CI -1231.3 to -739.1; p < 0.01), GLS (MD -2.5 %; 95 % CI -3.6 to -1.4; p < 0.01;), and E/e' (MD -1.99; 95 % CI 3.7 to -0.1; p = 0.03). LVEF (MD 7.3 %; 95 % CI 5.4 to 9.2; p < 0.01) with S/V treatment relative to baseline. CONCLUSION: In patients with HFrEF due to CTRCD, S/V significantly improved the clinical and echocardiographic parameters of left ventricular systolic and diastolic functions.
Mitochondrial calcium homeostasis and atrial fibrillation: Mechanisms and therapeutic strategies review.
Chang Y, Zou Q
Curr Probl Cardiol · 2025 Mar · PMID 39828107 · Publisher ↗
Atrial fibrillation (AF) is tightly linked to mitochondrial dysfunction, calcium (Ca²⁺) imbalance, and oxidative stress. Mitochondrial Ca²⁺ is essential for regulating metabolic enzymes, maintaining the tricarboxylic aci...
Atrial fibrillation (AF) is tightly linked to mitochondrial dysfunction, calcium (Ca²⁺) imbalance, and oxidative stress. Mitochondrial Ca²⁺ is essential for regulating metabolic enzymes, maintaining the tricarboxylic acid (TCA) cycle, supporting the electron transport chain (ETC), and producing ATP. Additionally, Ca²⁺ modulates oxidative balance by regulating antioxidant enzymes and reactive oxygen species (ROS) clearance. However, Ca²⁺ homeostasis disruptions, particularly overload, result in excessive ROS production, mitochondrial permeability transition pore (mPTP) opening, and oxidative stress-induced damage. These changes lead to mitochondrial dysfunction, Ca²⁺ leakage, and cardiomyocyte apoptosis, driving AF progression and atrial remodeling. Therapeutically, targeting mitochondrial Ca²⁺ homeostasis shows promise in mitigating AF. Moderate Ca²⁺ regulation enhances energy metabolism, stabilizes mitochondrial membrane potential, and bolsters antioxidant defenses by upregulating enzymes like superoxide dismutase and glutathione peroxidase. This reduces ROS generation and facilitates clearance. Proper Ca²⁺ levels also prevent electron leakage and promote mitophagy, aiding in damaged mitochondria removal and reducing ROS accumulation. Future strategies include modulating Ryanodine receptor 2 (RyR2), mitochondrial calcium uniporter (MCU), and sodium-calcium exchanger (NCLX) to control Ca²⁺ overload and oxidative damage. Addressing mitochondrial Ca²⁺ dynamics offers a compelling approach to breaking the cycle of Ca²⁺ overload, oxidative stress, and AF progression. Further research is needed to clarify the mechanisms of mitochondrial Ca²⁺ regulation and its role in AF pathogenesis. This knowledge will guide the development of innovative treatments to improve outcomes and quality of life for AF patients.
Guideline-directed medical therapy for heart failure: Real-world evidence in one Latin-American center.
Jiménez JM, Restrepo LJ, Villa M … +4 more , Gutiérrez S, Villarreal I, Vanegas JM, Díaz-Betancur JS
Curr Probl Cardiol · 2025 Mar · PMID 39828106 · Publisher ↗
BACKGROUND: Despite recommendations from clinical practice guidelines to initiate four drug classes in patients with heart failure (HF) with reduced ejection fraction, information on real-world implementation remains lim...
BACKGROUND: Despite recommendations from clinical practice guidelines to initiate four drug classes in patients with heart failure (HF) with reduced ejection fraction, information on real-world implementation remains limited. This study evaluated the medications initiated and titrated, the time until the optimal treatment tolerated, pharmacological profiles, patient's adherence, and causes of non-use of guideline directed-medical therapy (GDMT) in a cohort of patients with HF. METHODS: A retrospective cohort study was conducted on patients treated in a heart failure program in Colombia. Optimal treatment tolerated was defined as that achieved within 6 months of follow-up. Medication adherence was assessed using the 4-item Morisky-Green scale. RESULTS: A total of 471 patients were included, with a median age of 76 years, 56.9 % male, and a median left ventricular ejection fraction of 35 %. Overall, 43.9 % of patients were on GDMT quadruple therapy, with a median time to optimal tolerated treatment of 57 days (IQR: 1-133). More than 90 % reached target doses with mineralocorticoid receptor antagonists and SGLT2 inhibitors, while less than 50 % achieved it with beta-blockers and renin-angiotensin-aldosterone system inhibitors. Adherence, according to the Morisky-Green scale, was 89.9 % and main causes of non-adherence were lack of social-family support (46.8 %) and forgetting to take medication (44.7 %). CONCLUSIONS: In this real-world study of patients with HF, GDMT use rates were higher than those previous national registries. However, the medication doses were lower than those recommended by clinical guidelines. Identifying and quantifying adherence barriers in low- or middle-income countries is essential for implementing recommendations in clinical practice.
In-hospital outcomes of percutaneous left ventricular assist device recipients in cardiogenic shock hospitalizations with chronic kidney disease: A nationwide analysis.
Jain A, Modi K, Vyas A … +11 more , Raval M, Mirzakhanian A, Nayak PR, Desai R, Subramaniam V, Garikapati K, Doshi R, Dani SS, Bennett W, Lavie CJ, Soto JT
Curr Probl Cardiol · 2025 Mar · PMID 39828105 · Publisher ↗
BACKGROUND: There is a lack of data on the role of chronic kidney disease (CKD) in patients who received percutaneous left ventricular assist devices (pLVAD) as mechanical circulatory support (MCS) as an adjunct treatmen...
BACKGROUND: There is a lack of data on the role of chronic kidney disease (CKD) in patients who received percutaneous left ventricular assist devices (pLVAD) as mechanical circulatory support (MCS) as an adjunct treatment for cardiogenic shock (CS) management. METHODS: Using National Inpatient Sample (2016-19), we extracted CS patients receiving pLVAD and divided them into CKD and non-CKD cohorts. Multivariate regression analysis was used for adjusted odds ratios for outcomes before and after entropy balancing (EB) and predictive margins for the probability of all-cause in-hospital mortality (ACM). ACM was also compared between CS patients who did not receive MCS. RESULTS: In our study, 29,515 patients received pLVAD as the only MCS device in CS, and the prevalence of CKD amongst them was 9.7 %. After EB, ACM did not differ in CS with and without CKD (aOR 1.008, p = 0.953). Higher adjusted incidence rate ratios (IRR) were noted for length of stay (LOS) (aOR 1.68, p < 0.001) and hospitalization cost (aOR 1.365, p = 0.001) in CS with CKD. Mean LOS and hospitalization cost was significantly higher in CKD cohort before and after EB (post-EB: 17.4 days vs. 10.3 days, p < 0.001 and USD 652097 vs. 482359, p = 0.001, respectively). ACM was significantly higher in CS patients who did not receive any MCS if they had CKD (aOR 1.26, p < 0.001). CONCLUSION: CKD patients receiving pLVAD for CS had no difference in ACM but had higher resource utilization than those without CKD. pLVAD use was associated with a lower ACM in CKD patients when compared to patients who did not receive any MCS.
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