Clinical Cardiology

BACKGROUND: Aim of the study was to collect and describe a case series of consecutive master athletes in whom an anomalous origin of left circumflex artery (LCx) from the right sinus of Valsalva (ALCx) was detected at a clinically indicated coronary computed tomography angiography CCTA) to establish a focused clinical management and counseling about sport activity in those subjects. METHODS: We analyzed a prospective registry of subjects referred to a clinically indicated CCTA...

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Coronary heart disease (CHD) is a life-threatening condition that poses a significant risk to individuals. Mendelian randomization (MR) is an emerging epidemiological research method that offers substantial advantages in identifying risk factors for diseases. Currently, there are ongoing CHD-related MR studies. To gain comprehensive insights into the focal areas and trends of CHD-related MR research, this study utilizes bibliometrics to conduct an in-depth analysis of CHD-related MR articles published in the core database of Web of Science (WOS) from 2009 to 2023...

BACKGROUND: Maintaining ideal cardiovascular health scores (CHS) may indirectly contribute to reducing the risk of perioperative acute kidney injury (AKI), which has never been explored previously. In this study, we aimed to explore the relationship between CHS and AKI and provide new ideas for AKI prevention and treatment. METHODS: We examined the effects of CHS on the occurrence of AKI among 2783 participants from the Kailuan study, who received general anesthesia during noncardiac surgery from 2016 to 2020...

BACKGROUND: Acute ST-elevation myocardial infarction (STEMI) is a leading cause of mortality and morbidity worldwide, and primary percutaneous coronary intervention (PCI) is the preferred treatment option. HYPOTHESIS: Machine learning (ML) models have the potential to predict adverse clinical outcomes in STEMI patients treated with primary PCI. However, the comparative performance of different ML models for this purpose is unclear. METHODS: This study used a retrospective registry-based design to recruit consecutive hospitalized patients diagnosed with acute STEMI and treated with primary PCI from 2011 to 2019, at Tehran Heart Center, Tehran, Iran...

Artificial intelligence (AI) represents a rapidly developing field. Its use can improve diagnosis and therapy in many areas of medicine. Despite this enormous progress, many physicians perceive it as a black box and are skeptical about it. This review will present the basics of machine learning. Different classifications of artificial intelligence, such as supervised versus unsupervised and discriminative versus generative AI, are given. Analogies to human intelligence are discussed as far as algorithms are oriented toward it...

INTRODUCTION: Sodium-glucose cotransporter 2 (SGLT2) inhibitors are emerging antidiabetic agents with various potential cardiovascular benefits. The EMPT-ANGINA trial examined the effect of empagliflozin on the angina burden in those with concurrent type 2 diabetes mellitus (T2DM) and refractory angina (RA). METHOD: In this 8-week, double-blind, randomized, placebo-controlled trial, 75 patients with T2DM and RA were randomly assigned to one of two groups: empagliflozin (n = 37) and placebo (n = 38)...

BACKGROUND: Hypertrophic cardiomyopathy (HCM) is a common cardiac genetic disorder that clinically manifests with sudden death and progressive heart failure. Moreover, thyroid dysfunction is associated with increased cardiovascular morbidity and mortality risks. Therefore, this study aimed to clarify whether thyroid hormones could serve as an independent predictor of adverse events in patients with HCM. METHODS: The cohort consisted of 782 patients with HCM who had thyroid hormones baseline data and were admitted to the Affiliated Hospital of Jiaxing University...

BACKGROUND: It is unclear whether long-term heavy alcohol use leads to early cardiac function decline. HYPOTHESIS: Long-term heavy alcohol use developed reduced cardiac function in subclinical status by analyzing myocardial work (MW). Epicardial adipose tissue (EAT) volume and serum biomarkers contribute to identify potential factors sensitive in predicting early cardiac function decline. METHODS: We enrolled 31 asymptomatic participants with heavy alcohol use and 33 age and sex-matching nondrinking individuals...

AIMS: To explore the mediational effect of activities of daily living (ADL) and kinesiophobia on the cardiac function and health status of patients with chronic heart failure (CHF). METHODS: From October 2021 to January 2022, a total of 244 CHF patients treated in the Department of Cardiology of general hospitals were recruited by the convenience sampling method. They were investigated with the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), the Barthel index for assessing ADL, and the EuroQol five-dimensional questionnaire (EQ-5D) for assessing the health status...

Immune checkpoint inhibitors (ICIs), including antiprogrammed cell-death (PD)-1/anti-PD-ligand (PDL-1) monoclonal antibodies, are effective at improving the prognosis of patients with cancer. Among immune-related adverse events, myocarditis associated with anti-PD-1/anti-PD-L1 antibodies is rare but lacks effective treatment and mortality is very high. In this study, the authors extracted data from the previous 8 years from electronic medical records housed in the hospital information system to identify patients hospitalized with myocarditis putatively caused by anti-PD-1/anti-PD-L1 tumor therapy...

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BACKGROUND: Randomized trials show inconsistent estimates on risks of direct-acting oral anticoagulants (DOACs) versus warfarin in bleeding and mortality for atrial fibrillation (AF) patients. Trials are confounded by additional DOAC adherence support, while warfarin has a low time in therapeutic range. Few real-world studies compared emergency hospitalization risk between DOAC and warfarin users in AF. This study aimed to determine emergency hospitalization risk for AF patients on DOACs or warfarin in real-world settings...

BACKGROUND: Previous studies show that oxidative stress is important in heart failure (HF) pathogenesis. The composite dietary antioxidant index (CDAI), which reflects the antioxidant profile of nutrient supplements, is associated with cardiovascular mortality risk. However, the association between CDAI and the risk of HF remains unknown. HYPOTHESIS: In this study, we investigated the relationship between CDAI and HF risk using National Health and Nutritional Examination Survey (NHANES) data...

Lifestyle optimization is one of the most essential components of cardiovascular disease prevention. Motivational counseling provided by health care professionals could promote lifestyle modification. The purpose of the review is to identify possible evidence-based psychological principles that may be applicable to motivational counseling in the prevention of cardiovascular disease. These motivational communication skills promote behavioral change, improved motivation and adherence to cardiovascular disease prevention...

BACKGROUND: Frailty is an issue in patients with heart failure (HF). A Korean version of the frailty scale (K-FRAIL) has been developed. HYPOTHESIS: We aimed to analyze the relationship between the K-FRAIL scale and physical performance in patients with HF. METHODS: This study included 142 patients with HF aged ≥65 years from a single center. Muscular fitness was assessed using the handgrip test and knee extensor strength measurement...

BACKGROUND AND HYPOTHESIS: The objective of this study was to identify the characteristics of electrocardiogram (ECG) in adult patients with patent foramen ovale (PFO) and to analyze the predictive value of the characteristics of ECG for PFO in adult patients. METHODS: Retrospectively, 267 patients who had undergone ECG, transthoracic echocardiography (TTE), transesophageal echocardiography (TEE) with agitated saline contrast echocardiography in our hospital, were recruited continuously from January 2021 to March 2023...

BACKGROUND: The hybrid strategy of a combination of drug-eluting stent (DES) and drug-coated balloon (DCB) is promising for the treatment of de novo diffuse coronary artery disease (CAD). HYPOTHESIS: To investigate the efficacy and functional results of hybrid strategy. METHODS: This case series study included patients treated with a hybrid approach for de novo diffuse CAD between February 2017 and November 2021. Postprocedural quantitative flow ratio (QFR) was used to evaluate the functional results...

BACKGROUND: Immune and inflammatory responses have a pivotal role in the pathogenesis of rheumatoid arthritis (RA) and atherosclerotic cardiovascular disease (ASCVD). This study aims to explore the change of peripheral lymphocytes, especially the absolute and relative changes in peripheral T cells in RA patients with and without ASCVD. HYPOTHESIS: The changes in the lymphocyte subsets were assessed to provide a novel insight in diagnosing and preventing ASCVD in patients with RA...

BACKGROUND: Because of the advancement of bioabsorbable polymers and thinner struts, bioabsorbable-polymer sirolimus-eluting stents (BP-SES) with ultrathin struts may be related to superior performance when compared to durable-polymer drug-eluting stents (DP-DES) with thin struts. Nonetheless, the long-term safety of ultrathin BP-SES in acute coronary syndrome (ACS) remains unknown. METHODS: We sought to assess the long-term safety of ultrathin BP-SES in ACS patients, conducting a thorough meta-analysis of all relevant trials drawing a comparison between ultrathin BP-SES and contemporary thin DP-DES...