Kichou B, Bouraghda A, Lahmar HMA
… +9 more, Amara S, Aoudia Y, Benchabi Y, Haddoum F, Kachenoura A, Laredj N, Manamani L, Bouafia MTC, Chettibi M
Future Cardiol
· 2025 Mar · PMID 39943810
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Around one-third of adults in Algeria have hypertension, but > 40% are unaware they have the disease, and of those receiving treatment, only ~ 20-30% have adequate blood pressure (BP) control. Recommended starting treatm...Around one-third of adults in Algeria have hypertension, but > 40% are unaware they have the disease, and of those receiving treatment, only ~ 20-30% have adequate blood pressure (BP) control. Recommended starting treatment is an angiotensin converting enzyme inhibitor (ACEi) or angiotensin receptor blocker plus a calcium channel blocker (CCB) or diuretic. A single-pill combination of perindopril/amlodipine (ACEi/CCB) recently became available in Algeria. Twelve Algerian hypertension experts reviewed the clinical evidence regarding this therapeutic combination to determine its potential role for hypertension management in Algeria. The evidence indicated that this combination reduces cardiovascular outcomes and visit-to-visit BP variability, effectively controls 24-hour BP, and is well tolerated. In conclusion, the perindopril/amlodipine SPC provides a valuable new treatment option for hypertension in Algeria.
Khan U, Amin AM, Mohamed Taha A
… +7 more, Khlidj Y, M AlBarakat M, Elewidi M, Abuelazm M, Turkmani M, Abdelazeem B, Laeeq R
Future Cardiol
· 2025 Mar · PMID 39939290
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INTRODUCTION: Sodium-glucose cotransporter 2 inhibitors (SGLT2is) reduce cardiovascular events, especially in diabetic patients. However, the cardioprotective effects of early SGLT2i administration following acute myocar...INTRODUCTION: Sodium-glucose cotransporter 2 inhibitors (SGLT2is) reduce cardiovascular events, especially in diabetic patients. However, the cardioprotective effects of early SGLT2i administration following acute myocardial infarction (AMI) remain unclear. OBJECTIVE: This study aims to investigate the impact of SGLT2is on clinical outcomes in patients post-AMI. METHODS: A comprehensive search was conducted in PubMed, CENTRAL, WOS, Scopus, and EMBASE up to April 2024. Risk ratio (RR) was used for dichotomous outcomes and mean difference (MD) for continuous outcomes, with 95% confidence intervals (CI). RESULTS: Seven studies with 11,407 patients were included. SGLT2is did not significantly reduce the incidence of major adverse cardiovascular events (MACE) (RR = 0.94, 95% CI [0.68, 1.29], = 0.69), all-cause mortality (RR = 1.01, 95% CI [0.84, 1.21], = 0.93), or stroke (RR = 0.61, 95% CI [0.29,1.28], = 0.19). However, SGLT2is significantly reduced the risk of heart failure (RR = 0.76, 95% CI [0.63, 0.91], < 0.01) and improved left ventricular ejection fraction (MD = 1.86, 95% CI [1.58, 2.14], < 0.01). CONCLUSION: In post-AMI patients, SGLT2is do not significantly affect MACE or mortality but are associated with reduced heart failure risk and improved ejection fraction. PROTOCOL REGISTRATION: PROSPERO identifier number: CRD42024506806.
Dimitriadis K, Pyrpyris N, Tatakis F
… +8 more, Kyriakoulis K, Pitsiori DE, Beneki E, Fragkoulis C, Konstantinidis D, Kollias A, Aznaouridis K, Tsioufis K
Future Cardiol
· 2025 Mar · PMID 39924226
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Arterial hypertension is one of the most prevalent cardiovascular pathologies worldwide. Considering the increased rates of uncontrolled hypertension and treatment non-adherence, catheter-based methods, with the most pro...Arterial hypertension is one of the most prevalent cardiovascular pathologies worldwide. Considering the increased rates of uncontrolled hypertension and treatment non-adherence, catheter-based methods, with the most prominent being renal denervation, have been recently included in international guidelines for the management of the pathology, naming the method the third pillar in hypertension management. However, sympathetic overactivation is not only a major pathophysiologic driver in hypertension, but in other cardiovascular pathologies as well. Considering the effect of renal denervation in hypertension-mediated target organ damage, as well as the pleotropic effects of this modality, recent evidence have evaluated the modality in coronary microvascular dysfunction (CMD). Interestingly, despite preclinical data showcase a benefit of renal denervation in microcirculatory homeostasis, with enhancement of endothelial-mediated vasodilation and reduction of inflammation, these effects have failed to be translated into clinical benefit, with the limited, to date, non-interventional studies in coronary microcirculation reporting neutral effects. Therefore, this review aims to delineate the pathophysiological processes which relate microvascular dysfunction with hypertension, discuss the effect of the procedure in hypertension-mediated target organ damage, analyze preclinical and clinical data on the safety and efficacy of renal denervation in improving microcirculatory indices, as well as provide future directions for this novel field.
Bottussi A, D'Andria Ursoleo J, Agosta VT
… +2 more, De Luca M, Monaco F
Future Cardiol
· 2025 Mar · PMID 39921856
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Acute kidney injury (AKI) persists as one of the most common complications after cardiac surgery. Beyond being burdened by high morbidity and mortality rates, effective therapeutic options are still lacking. To date, the...Acute kidney injury (AKI) persists as one of the most common complications after cardiac surgery. Beyond being burdened by high morbidity and mortality rates, effective therapeutic options are still lacking. To date, the management of cardiac surgery-associated AKI (CSA-AKI) mainly focuses on preventive strategies, e.g. the implementation of standardized care bundles. Interestingly, recent experimental studies have suggested a potential nephroprotective role for both amino acids (AA) and proteins. As such, these compounds show multiple beneficial renal effects, spanning enhancement of renal blood flow, improved oxygenation, and recruitment of renal functional reserve. Moreover, clinical studies have investigated the therapeutic potential of single AA, AA combinations, and proteins. A recent large multicenter randomized controlled trial showed reduced AKI incidence in cardiac surgery patients receiving intravenous AA supplementation. However, these interventions have not yet demonstrated beneficial effects on major clinical outcomes, such as survival. Given the well-established AA safety profile and the underlying biological rationale supporting their use, this review summarizes the existing literature on the effects of various formulations and combinations of perioperative AA and protein on renal outcomes when administered in cardiac surgery patients.
Albulushi A, Al-Asmi S, Al-Abri M
… +1 more, Al-Farhan H
Future Cardiol
· 2025 Feb · PMID 39895237
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BACKGROUND: Group II Pulmonary Hypertension (PH) secondary to Heart Failure with preserved Ejection Fraction (HFpEF) is associated with significant morbidity and mortality. Lipoprotein(a) [Lp(a)] is a novel biomarker imp...BACKGROUND: Group II Pulmonary Hypertension (PH) secondary to Heart Failure with preserved Ejection Fraction (HFpEF) is associated with significant morbidity and mortality. Lipoprotein(a) [Lp(a)] is a novel biomarker implicated in cardiovascular pathology, yet its role in myocardial fibrosis within this population remains underexplored. This study investigates the association between elevated Lp(a) levels and cardiac fibrosis to improve understanding of its prognostic and diagnostic utility. METHODS: This retrospective cohort study included 100 patients with Group II PH secondary to HFpEF. Serum Lp(a) levels were quantified using enzymatic assays, and myocardial fibrosis was assessed using Cardiac Magnetic Resonance Imaging (CMR) techniques, including T1 mapping and late gadolinium enhancement (LGE). Statistical models adjusted for confounding factors. RESULTS: Elevated Lp(a) levels were significantly associated with increased myocardial extracellular volume (31% vs. 27%, < 0.01), prolonged native T1 times, and increased odds of myocardial scar formation. Structural cardiac changes correlated with Lp(a) concentrations. CONCLUSION: Elevated Lp(a) is a key marker of myocardial fibrosis and structural remodeling in Group II PH secondary to HFpEF. Routine Lp(a) measurement may enhance risk stratification and inform therapeutic strategies.
Future Cardiol
· 2025 Feb · PMID 39885802
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BACKGROUND: ALERTS was a pivotal randomized clinical trial (RCT) evaluating an intracardiac monitor with real-time alerting in high-risk acute coronary syndrome patients. The cost-effectiveness however is unknown. METHOD...BACKGROUND: ALERTS was a pivotal randomized clinical trial (RCT) evaluating an intracardiac monitor with real-time alerting in high-risk acute coronary syndrome patients. The cost-effectiveness however is unknown. METHOD: A decision model estimated health effects and costs of implanting a Guardian device in a target patient population, compared to current standard-of-care (SOC). Health and economic outcomes were modeled using ALERTS trial results and relevant literature. RESULTS: Base-case analysis indicated an incremental lifetime cost of $21,988 with Guardian as compared to SOC (increase of 0.18 life years or 0.37 quality-adjusted life years (QALY)). The incremental cost-effectiveness ratio (ICER) was $121,056/LY or $58,668/QALY. CONCLUSION: Real-time intracardiac monitoring with patient alerting was cost-effective using conventional thresholds in acute coronary syndrome (ACS) patients at high-risk for recurrent events.
Shuja MH, Shuja SH, Shaheen F
… +4 more, Hannat R, Shakil F, Abbasi AF, Hasan M
Future Cardiol
· 2025 Mar · PMID 39882757
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BACKGROUND: Implantable cardioverter-defibrillators (ICDs) are essential for reducing sudden cardiac death in patients at risk of ventricular arrhythmias. The choice of ICD lead - single-coil or dual-coil - can influence...BACKGROUND: Implantable cardioverter-defibrillators (ICDs) are essential for reducing sudden cardiac death in patients at risk of ventricular arrhythmias. The choice of ICD lead - single-coil or dual-coil - can influence device performance and patient outcomes. This meta-analysis evaluates the comparative efficacy and safety of single-coil versus dual-coil ICD leads to inform clinical decision-making. METHODS: A systematic search of PubMed, Cochrane Library, and Google Scholar was performed up to October 2024. Only randomized controlled trials (RCTs) comparing single-coil and dual-coil ICD leads were included. Outcomes assessed included defibrillation threshold (DFT), first-shock efficacy, all-cause mortality, cardiovascular mortality, shock impedance, and peak current. RESULTS: Seven RCTs involving 1,614 patients were analyzed. Single-coil leads demonstrated superior first-shock efficacy (OR: 1.60; = 0.05), reduced all-cause mortality (RR: 0.63; = 0.02), and better peak current (MD: -2.29; = 0.02). DFT and cardiovascular mortality were comparable between groups, while dual-coil leads exhibited lower shock impedance (MD: 18.26; < 0.00001). CONCLUSIONS: Single-coil ICD leads are associated with improved first-shock efficacy and reduced all-cause mortality, suggesting their potential superiority in certain patient populations. Further research is warranted to refine lead selection criteria.
Kyriakoulis I, Tzoumas A, Kyriakoulis KG
… +5 more, Kardoutsos I, Ntoumaziou A, Nagraj S, Kokkinidis DG, Palaiodimos L
Future Cardiol
· 2025 Feb · PMID 39882735
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BACKGROUND: Infective endocarditis is characterized by the colonization of heart valves by virulent microorganisms. It commonly manifests as involvement of a single heart valve -single-valve infective endocarditis (SIE),...BACKGROUND: Infective endocarditis is characterized by the colonization of heart valves by virulent microorganisms. It commonly manifests as involvement of a single heart valve -single-valve infective endocarditis (SIE), while in some patients, two or more heart valves are concomitantly infected -multivalvular infective endocarditis (MIE). The risk of complications and prognosis of MIE as opposed to SIE are unknown. METHODS: We performed a systematic search in MEDLINE and Scopus for studies of patients with MIE and SIE. The outcomes of interest included mortality, heart failure, systemic embolic events, and need for surgery. RESULTS: Οf 1,124 identified studies, eleven met the inclusion criteria. MIE was reported in 20.4% of the total patients. Compared to SIE, MIE was associated with increased risk of short-term mortality (RR: 1.29, 95% CI: 1.19-1.39), one-year mortality (RR: 1.20, 95% CI: 1.08-1.34), heart failure (RR: 1.31, 95% CI: 1.12-1.54), systemic embolic events (RR: 1.12, 95% CI: 1.02-1.22), and need for subsequent surgical management (RR: 1.22, 95% CI: 1.05-1.41). CONCLUSIONS: Patients with MIE have a higher likelihood of poor prognosis compared to patients with SIE. A high clinical suspicion of this condition and timely diagnosis and management are imperative while managing patients with infective endocarditis. PROTOCOL REGISTRATION: PROSPERO CRD42023486674.
Soman P, Khouri MG, Lenihan D
… +8 more, Reyentovich A, Sperry BW, Sowalsky K, Bai Y, Du J, Katz L, Siddhanti S, Fox JC
Future Cardiol
· 2025 Feb · PMID 39878480
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INTRODUCTION: The 6-minute walk test (6MWT) is used to assess submaximal exercise capacity in clinical trials. Conducting the 6MWT can be challenging when patients cannot visit the clinic due to physical/travel limitatio...INTRODUCTION: The 6-minute walk test (6MWT) is used to assess submaximal exercise capacity in clinical trials. Conducting the 6MWT can be challenging when patients cannot visit the clinic due to physical/travel limitations. This pilot study assessed the feasibility of conducting the 6MWT using wearable sensors for patients with transthyretin amyloid cardiomyopathy. METHODS: Participants were enrolled in the phase 3 ATTRibute-CM trial. Sensors were positioned on patients' feet and lower back during the 6MWT. The 6-minute walk distance (6MWD) was compared with the distance measured by a trained observer during a concurrent conventional test. Pearson and concordance correlation coefficients were estimated. RESULTS: Twelve participants from five centers participated; 11 had evaluable data. Mean 6MWD was 330.3 m (conventional method) and 335.1 m (wearable sensors); mean difference (SD) was 4.7 m (10.95). Pearson and concordance correlation coefficients for 6MWD were 0.998 (95% CI: 0.992-0.999) and 0.997 (95% CI: 0.991-0.999), respectively. CONCLUSIONS: The 6MWD measured using wearable sensors and by the conventional method were closely correlated. Conducting the 6MWT with wearable sensors may be feasible and as reliable as the conventional method in a monitored clinic setting. Whether at-home 6MWD measured by wearable sensors correlates with in-clinic monitoring deserves further study. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov identifier is NCT03860935.
Khesali H, Ghaffari Jolfayi A, Soheili A
… +3 more, Rezapour P, Adimi S, Alirezaei T
Future Cardiol
· 2025 Feb · PMID 39874020
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INTRODUCTION: Decreased left atrial appendage emptying velocity (LAAV) is a marker for thrombus formation. This study evaluates the association between LAAV and inflammatory indices in non-valvular atrial fibrillation (A...INTRODUCTION: Decreased left atrial appendage emptying velocity (LAAV) is a marker for thrombus formation. This study evaluates the association between LAAV and inflammatory indices in non-valvular atrial fibrillation (AF) patients. METHODS: The study population was 1428 patients with AF, 875 of whom enrolled. Based on the LAAV, patients were divided into three groups of 262 patients with a velocity of <25 cm/s, 360 patients with a velocity of 25 to 55 cm/s, and 253 patients with a velocity of >55 cm/s to assess and compare in terms of inflammatory indices, including the platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, systemic immune inflammation index, neutrophil - to - platelet ratio and white blood cell-to-platelet ratio (WPR). RESULTS: There was no statistical difference in the level of inflammatory indices between the three groups, and none of them were related to LAAV ( > .05) except WPR with a weak negative correlation ( = 0.01, = -0.10). Patients with lower LAAV were found to have a higher age ( = 0.001), decreased left ventricular ejection fraction ( = 0.001) and greater left atrial volume index ( = 0.001). CONCLUSION: This study did not show any association between inflammatory indices and LAAV in non-valvular AF patients except for the WPR.
Deng MX, Vervoort D, Valverde I
… +5 more, Yoo SJ, Peel B, Vanderlaan RD, Barron DJ, Honjo O
Future Cardiol
· 2025 Feb · PMID 39862146
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Reaching competency in congenital heart surgery (CHS) requires lengthy and rigorous training. Due to patient safety, time limitations, and procedural complexity, the intraoperative setting is not ideal for technical prac...Reaching competency in congenital heart surgery (CHS) requires lengthy and rigorous training. Due to patient safety, time limitations, and procedural complexity, the intraoperative setting is not ideal for technical practice. Surgical simulation using synthetic, biological, or virtual models is an increasingly valuable educational tool for technical training and assessment. In particular, three-dimensional (3D) models are especially favorable in CHS education for its high-fidelity demonstration of congenital heart defects. In countries where there is a deficit of local cardiac surgical expertise, simple and inexpensive innovation, such as expanding hands-on technical training programs involving 3D-models and hybrid teaching, may partially address the lack of CHS training opportunities and the consequent unmet need for surgical management of pediatric heart disease.
Elhamdani A, Vashistha K, Alhuneafat L
… +5 more, Altarawneh T, Biederman R, Wilson JT, Aronow WS, Nguyen V
Future Cardiol
· 2025 Mar · PMID 39846891
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Approximately 5-10% of patients with hypertension have secondary hypertension. We describe a case of secondary hypertension from bilateral renal artery stenosis (RAS): "Pickering syndrome." This is a case of hypertension...Approximately 5-10% of patients with hypertension have secondary hypertension. We describe a case of secondary hypertension from bilateral renal artery stenosis (RAS): "Pickering syndrome." This is a case of hypertension secondary to bilateral RAS which provides an opportunity to review secondary hypertension with a specific focus on RAS, in terms of when to consider work up, causes of secondary hypertension, diagnostic testing, and treatment.
King N, Smart NA, Bungon T
… +2 more, Peacock M, Awan SA
Future Cardiol
· 2025 Jan · PMID 39812324
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INTRODUCTION: Little information exists regarding the detection of early coronary heart disease protein biomarkers. The aim of this study was to investigate several potential candidates. METHODS: Systematic review was ca...INTRODUCTION: Little information exists regarding the detection of early coronary heart disease protein biomarkers. The aim of this study was to investigate several potential candidates. METHODS: Systematic review was carried out followed by meta-analysis. RESULTS: The standardized mean difference (95% confidence intervals) for each comparison was: Troponins 2.31 (1.18, 3.4), iL-6 1.3 (0.8, 1.81), fibrinogen 1.55 (1.16, 1.94), NT-proBNP 1.05 (0.72, 1.38), lipoprotein a 0.75 (0.48, 1.03) osteoprotegerin 0.92 (0.23, 1.62), VCAM-1 1.53 (0.87, 2.18), pentraxin 3 0.87 (-0.13, 1.87), PAI-1 2.51 (-0.65, 5.66) MMP9 1.25 (0.36, 2.14), MCP-1 1.99 (1.12, 2.85) and adiponectin -1.11 (-1.49, -0.73). CONCLUSION: Multiple biomarkers that could potentially be used for the early detection of coronary heart disease were identified.
Caffè A, Scarica V, Animati FM
… +3 more, Manzato M, Bonanni A, Montone RA
Future Cardiol
· 2025 Jan · PMID 39786972
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The recently introduced concept of 'exposome' emphasizes the impact of non-traditional threats onto cardiovascular health. Among these, air pollutants - particularly fine particulate matter < 2.5 μm (PM2.5) - have emerge...The recently introduced concept of 'exposome' emphasizes the impact of non-traditional threats onto cardiovascular health. Among these, air pollutants - particularly fine particulate matter < 2.5 μm (PM2.5) - have emerged as significant environmental risk factors for cardiovascular disease and mortality. PM2.5 exposure has been shown to induce endothelial dysfunction, chronic low-grade inflammation, and cardiometabolic impairment, contributing to the development and destabilization of atherosclerotic plaques. Both short- and long-term exposure to air pollution considerably increase the incidence of ischemic heart disease (IHD)-related events, with clinical evidence linking pollution to higher mortality and adverse prognosis, especially in vulnerable populations. In this review, we explore the mechanistic pathways through which air pollutants exacerbate atherosclerotic cardiovascular disease (ASCVD) and discuss their clinical impact.Furthermore, special attention will be directed to the outcomes and prognosis of patients with pollution-aggravated coronary atherosclerosis, as well as the potential role of targeted public health interventions.
Contorno E, Javed H, Steen L
… +6 more, Lowery J, Zaghw A, Duerksen A, Henrich-Lobo R, Reemtsen B, Rajab TK
Future Cardiol
· 2025 Jan · PMID 39781900
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Heart valve replacement is indicated for children with irreparable heart valve disease. These replacements come in a variety of forms including mechanical, xenograft tissue, allograft tissue, and autograft tissue valves....Heart valve replacement is indicated for children with irreparable heart valve disease. These replacements come in a variety of forms including mechanical, xenograft tissue, allograft tissue, and autograft tissue valves. These options each have unique benefits and risks profiles. Mechanical valves are the most structurally durable; however, they represent significant thrombogenic risks and require anticoagulant therapy. Xenograft and homograft tissue valves do not carry the thrombogenic risks found with mechanical valves but also do not have the structural integrity of mechanical valves. Importantly, neither of these options allows for the somatic growth, requiring serial reoperation to implant upsized valves. Autograft implantation and partial heart transplantation each allow for the implantation of growing valves; however, autografts require for either a mechanical or bioprosthetic valve to be fitted into another valve position and PHT requires immunosuppressive medication to allow for the growth of the valve. In summary, outcomes of valve implantation in the pediatric population are significantly subpar compared to the outcomes enjoyed by the adult population. To remedy this, further innovation is needed in heart valve replacement technology.