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Balloon Valvuloplasty in Congenital Critical Aortic Valve Stenosis in Neonates and Infants: A Rescue Procedure for the Left Ventricle
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Improved Interpretation of Pulmonary Artery Wedge Pressures through Left Atrial Volumetry—A Cardiac Magnetic Resonance Imaging Study
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Prevalence and Clinical Significance of Intraventricular Conduction Disturbances in Hospitalized Children
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Photon-Counting Detector Computed Tomography (PCD-CT): A New Era for Cardiovascular Imaging? Current Status and Future Outlooks
Journal Description
Journal of Cardiovascular Development and Disease
Journal of Cardiovascular Development and Disease
is an international, scientific, peer-reviewed, open access journal on cardiovascular medicine published monthly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, Embase, CAPlus / SciFinder, and other databases.
- Journal Rank: JCR - Q2 (Cardiac and Cardiovascular Systems) / CiteScore - Q2 (General Pharmacology, Toxicology and Pharmaceutics )
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 22.9 days after submission; acceptance to publication is undertaken in 2.6 days (median values for papers published in this journal in the first half of 2024).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Impact Factor:
2.4 (2023);
5-Year Impact Factor:
2.6 (2023)
Latest Articles
Advanced Echocardiography Assessment in the Management of Alcapa Syndrome: Case Report
J. Cardiovasc. Dev. Dis. 2024, 11(7), 219; https://doi.org/10.3390/jcdd11070219 - 11 Jul 2024
Abstract
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare and potentially life-threatening condition affecting infants that requires immediate corrective surgery to restore blood flow to the myocardium. We present a case of an infant with ALCAPA and
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Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare and potentially life-threatening condition affecting infants that requires immediate corrective surgery to restore blood flow to the myocardium. We present a case of an infant with ALCAPA and severe heart failure. What sets this case apart is the utilization of speckle-tracking echocardiography as a non-invasive method for assessing global and regional myocardial function before and after surgical intervention. Our preoperative analysis revealed compromised contraction in specific areas of the left ventricle (LV), in the regions that were supplied by both the left coronary artery (LCA) and the right coronary artery (RCA). Interestingly, despite an increase in ejection fraction (EF) measured by conventional echocardiography, the postoperative speckle-tracking analysis revealed persistent impairment in the anterior territories supplied by LCA, highlighting the potential of this technique in identifying myocardial abnormalities during postoperative follow-up. In conclusion, speckle-tracking echocardiography may be a valuable tool for identifying subtle myocardial changes in ALCAPA patients with a higher sensitivity in detecting regional left ventricular (LV) dysfunction compared to conventional echocardiography.
Full article
(This article belongs to the Special Issue Heart Diseases in Children)
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Arrhythmic Mitral Valve Prolapse Syndrome and Ventricular Arrhythmias: A Comprehensive Review and the Role of Catheter Ablation
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Ehsan Mahmoodi and Haris M. Haqqani
J. Cardiovasc. Dev. Dis. 2024, 11(7), 218; https://doi.org/10.3390/jcdd11070218 - 10 Jul 2024
Abstract
Mitral valve prolapse (MVP) affects 2–3% of the general population, and despite its benign prognosis overall, it is associated with sudden death in a small subset of patients. The term “arrhythmic MVP syndrome” (AMVPS) refers to the presence of frequent or complex ventricular
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Mitral valve prolapse (MVP) affects 2–3% of the general population, and despite its benign prognosis overall, it is associated with sudden death in a small subset of patients. The term “arrhythmic MVP syndrome” (AMVPS) refers to the presence of frequent or complex ventricular arrhythmias, commonly reported in female patients with a stereotypical phenotype including bileaflet myxomatous disease, ECG repolarisation abnormalities in inferior leads, mitral annular disjunction, and significant fibrosis in the inferolateral LV and papillary muscles. Modern imaging technologies have led to the identification of new risk factors that have been implemented in recent risk stratification guidelines; however, screening for patients with MVP who are at risk of sudden cardiac death (SCD) remains challenging. In addition, there is a limited amount of data on the outcomes of different treatment approaches in AMVP and no specific indication for targeted or disease-modifying therapies within current guidelines. Potential arrhythmic substrates in patients with AMVP syndrome have been the subject of interest in previous studies, with areas consisting of fibrosis at the papillary muscle level and the Purkinje system. Premature ventricular contractions (PVCs) originating from these areas have been shown to play an important role as triggers for ventricular fibrillation and SCD in patients with AMVP. Catheter ablation has emerged as a potential treatment modality in patients with MVP and ventricular arrhythmias (VAs), targeting arrhythmic substrates and triggering PVC foci. The aim of this review is to explore the role of catheter ablation in treating patients with AMVP.
Full article
(This article belongs to the Special Issue Arrhythmic Mitral Valve Prolapse: Risk Factors, Pathophysiology and Risk Stratification for Cardiac Arrhythmias)
Open AccessArticle
Factors Contributing to Coronary Microvascular Dysfunction in Patients with Angina and Non-Obstructive Coronary Artery Disease
by
Hiroki Teragawa, Yuko Uchimura, Chikage Oshita, Yu Hashimoto and Shuichi Nomura
J. Cardiovasc. Dev. Dis. 2024, 11(7), 217; https://doi.org/10.3390/jcdd11070217 - 10 Jul 2024
Abstract
Background: Coronary microvascular dysfunction (CMD), characterised by a reduced coronary flow reserve (CFR) or an increased index of microcirculatory resistance (IMR), has received considerable attention as a cause of chest pain in recent years. However, the risks and causes of CMD remain unclear;
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Background: Coronary microvascular dysfunction (CMD), characterised by a reduced coronary flow reserve (CFR) or an increased index of microcirculatory resistance (IMR), has received considerable attention as a cause of chest pain in recent years. However, the risks and causes of CMD remain unclear; therefore, effective treatment strategies have not yet been established. Heart failure or coronary artery disease (CAD) is a risk factor for CMD, with a higher prevalence among women. However, the other contributing factors remain unclear. In this study, we assessed the risk in patients with angina and non-obstructive coronary artery disease (ANOCA), excluding those with heart failure or organic stenosis of the coronary arteries. Furthermore, we analysed whether the risk of CMD differed according to component factors and sex. Methods: This study included 84 patients with ANOCA (36 men and 48 women; mean age, 63 years) who underwent coronary angiography and functional testing (CFT). The CFT included a spasm provocation test (SPT), followed by a coronary microvascular function test (CMVF). In the SPT, patients were mainly provoked by acetylcholine (ACh), and coronary spasm was defined as >90% transient coronary artery constriction on coronary angiography, accompanied by chest pain or ischaemic changes on electrocardiography. In 15 patients (18%) with negative ACh provocation, ergonovine maleate (EM) was administered as an additional provocative drug. In the CMVF, a pressure wire was inserted into the left anterior descending coronary artery using intravenous adenosine triphosphate, and the CFR and IMR were measured using previously described methods. A CFR < 2.0 or IMR ≥ 25 was indicative of CMD. The correlations between various laboratory indices and CMD and its components were investigated, and logistic regression analysis was performed, focusing on factors where p < 0.05. Results: Of the 84 patients, a CFR < 2.0 was found in 22 (26%) and an IMR ≥ 25 in 40 (48%) patients, with CMD identified in 46 (55%) patients. CMD was correlated with smoking (p = 0.020) and the use of EM (p = 0.020). The factors that correlated with a CFR < 2.0 included the echocardiograph index E/e′ (p = 0.013), which showed a weak but positive correlation with the CFR (r = 0.268, p = 0.013). Conversely, the factors correlated with an IMR ≥ 25 included RAS inhibitor usage (p = 0.018) and smoking (p = 0.042). Assessment of the risk of CMD according to sex revealed that smoking (p = 0.036) was the only factor associated with CMD in men, whereas the left ventricular mass index (p = 0.010) and low glycated haemoglobin levels (p = 0.012) were associated with CMD in women. Conclusions: Our results indicated that smoking status and EM use were associated with CMD. The risk of CMD differed between the two CMD components and sex. Although these factors should be considered when treating CMD, smoking cessation remains important. In addition, CMD assessment should be performed carefully when EM is used after ACh provocation. Further validation of our findings using prospective studies and large registries is warranted.
Full article
(This article belongs to the Special Issue Cardiovascular Disease: Risk Factors and Prevention)
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Open AccessArticle
Impact of Chronic Kidney Disease on the Coronary Revascularization Guided by Intracoronary Physiology: Results of the First Registry with Long-Term Follow-Up in a Latin American Population
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Clarissa Campo Dall’Orto, Rubens Pierry Ferreira Lopes, Lara Vilela Eurípedes, Gilvan Vilella Pinto Filho and Marcos Raphael da Silva
J. Cardiovasc. Dev. Dis. 2024, 11(7), 216; https://doi.org/10.3390/jcdd11070216 - 10 Jul 2024
Abstract
The use of invasive physiology methods in patients with renal dysfunction is not well elucidated. Our objective was to evaluate the in-hospital and long-term results of using intracoronary physiology to guide revascularization in patients with chronic kidney disease. In this retrospective study, we
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The use of invasive physiology methods in patients with renal dysfunction is not well elucidated. Our objective was to evaluate the in-hospital and long-term results of using intracoronary physiology to guide revascularization in patients with chronic kidney disease. In this retrospective study, we evaluated 151 patients from January 2018 to January 2022, divided into 2 groups: CKD (81 patients [114 lesions]) and non-CKD (70 patients [117 lesions]). The mean age was higher (p < 0.001), body mass index was lower (p = 0.007), contrast volume used was lower (p = 0.02) and the number of ischemic lesions/patients was higher (p = 0.005) in the CKD group. The primary outcomes (rate of major adverse cardiac events during follow-up, defined as death, infarction, and need for new revascularization) in the CKD and non-CKD groups were 22.07% and 14.92%, respectively (p = 0.363). There was a significant difference in the target lesion revascularization (TLR) rate (11.68%, CKD group vs. 1.49%, non-CKD group, p = 0.02), this initial statistical difference was not significant after adjusting for variables in the logistic regression model. There was no difference between the rates of death from all causes (6.49%, CKD group vs. 1.49%, non-CKD group, p = 0.15), reinfarction (3.89%, CKD group vs. 1.49%, non-CKD group, p = 0.394), and need for new revascularization (11.68%, CKD group vs. 5.97%, non-CKD group, p = 0.297). As there was no difference in the endpoints between groups with long-term follow-up, this study demonstrated the safety of using intracoronary physiology to guide revascularization in patients with CKD.
Full article
(This article belongs to the Special Issue How Should We Assess Stenosis for Revascularization: Fractional Flow Reserve (FFR) versus Intravascular Ultrasound (IVUS))
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Open AccessArticle
Improvement of Cardiac Function and Subcellular Defects Due to Chronic Diabetes upon Treatment with Sarpogrelate
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Paramjit S. Tappia, Vijayan Elimban, Anureet K. Shah, Ramesh K. Goyal and Naranjan S. Dhalla
J. Cardiovasc. Dev. Dis. 2024, 11(7), 215; https://doi.org/10.3390/jcdd11070215 - 9 Jul 2024
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In order to investigate the subcellular mechanisms underlying the beneficial effects of sarpogrelate—a 5-HT2A receptor antagonist—on diabetic cardiomyopathy, diabetes was induced in rats by injecting streptozotocin (65 mg/kg). Diabetic animals were treated with or without sarpogrelate (5 mg/kg daily) for 6 weeks;
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In order to investigate the subcellular mechanisms underlying the beneficial effects of sarpogrelate—a 5-HT2A receptor antagonist—on diabetic cardiomyopathy, diabetes was induced in rats by injecting streptozotocin (65 mg/kg). Diabetic animals were treated with or without sarpogrelate (5 mg/kg daily) for 6 weeks; diabetic animals were also treated with insulin (10 units/kg daily) for comparison. Elevated plasma levels of glucose and lipids, depressed insulin levels, hemodynamic alterations and cardiac dysfunction in diabetic animals were partially or fully attenuated by sarpogrelate or insulin treatment. Diabetes-induced changes in myocardial high-energy phosphate stores, as well as depressed mitochondrial oxidative phosphorylation and Ca2+-uptake activities, were significantly prevented by these treatments. Reductions in sarcolemma Na+-K+ ATPase, Na+-Ca2+ exchange, Ca2+-channel density and Ca2+-uptake activities were also attenuated by treatments with sarpogrelate and insulin. In addition, decreases in diabetes-induced sarcoplasmic reticulum Ca2+-uptake, Ca2+-release and Ca2+-stimulated ATPase activities, myofibrillar Mg2+-ATPase and Ca2+-stimulated ATPase activities, and myosin Mg2+-ATPase and Ca2+-ATPase activities were fully or partially prevented by sarpogrelate and insulin treatments. Marked alterations in different biomarkers of oxidative stress, such as malondialdehyde, superoxide dismutase and glutathione peroxidase, in diabetic hearts were also attenuated by treating the animals with sarpogrelate or insulin. These observations suggest that therapy with sarpogrelate, like that with insulin, may improve cardiac function by preventing subcellular and metabolic defects as a consequence of a reduction in oxidative stress.
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Open AccessArticle
Pharmacomechanical Thrombectomy and Catheter-Directed Thrombolysis, with or without Iliac Vein Stenting, in the Treatment of Acute Iliofemoral Deep Vein Thrombosis
by
Evren Ozcinar, Nur Dikmen, Ahmet Kayan, Melisa Kandemir and Mehmet Cahit Saricaoglu
J. Cardiovasc. Dev. Dis. 2024, 11(7), 214; https://doi.org/10.3390/jcdd11070214 - 9 Jul 2024
Abstract
Background: This study aims to evaluate and compare the outcomes and clinical efficacy of pharmacomechanical thrombectomy (PMCT) plus catheter-directed thrombolysis (CDT) and PMCT combined with CDT and venous stenting in managing acute iliofemoral deep vein thrombosis (DVT), while also assessing the long-term safety
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Background: This study aims to evaluate and compare the outcomes and clinical efficacy of pharmacomechanical thrombectomy (PMCT) plus catheter-directed thrombolysis (CDT) and PMCT combined with CDT and venous stenting in managing acute iliofemoral deep vein thrombosis (DVT), while also assessing the long-term safety and efficacy of these interventions. Methods: A retrospective case–control study spanning 3 years involved 112 patients presenting with acute symptomatic iliofemoral deep vein thrombosis (DVT), each with a symptom duration of less than 14 days. Patients were consecutively categorized into two groups based on individual clinical indications: PMCT + CDT vs. PMCT + CDT + venous stent. Statistical analyses were conducted to compare clinical features and outcomes between the two groups. Additionally, patients were followed up for 24 months post-treatment, during which quality of life (QoL) and severity of post-thrombotic syndrome (PTS) were analyzed. Results: In this retrospective study, we analyzed a total of 112 consecutive patients, with 63 patients undergoing PMCT + CDT and 49 patients undergoing PMCT + CDT + venous stent. Between the two groups, regarding primary outcomes at 6 months, there was no difference in the observed cumulative patency rates, standing at 82.5% for PMCT + CDT and 81.6% for PMCT + CDT + stent. Survival analyses for primary, primary-assisted, and secondary patency yielded comparable results for PMCT + CDT, with p-values of 0.74, 0.58, and 0.72, respectively. The two-year patency rate was high in both groups (85.7% for PMCT + CDT vs. 83.7% for PMCT + CDT + stent). Additionally, during the follow-up period, there were no statistically significant differences observed in the incidence of PTS or the average Villalta score between the two groups. At 24 months post-intervention, the incidence of post-thrombotic syndrome (PTS) was 11.1% in the PMCT + CDT group and 22% in the PMCT + CDT + stent group (p = 0.381). Both treatment arms of the study groups experienced bleeding complications during the thrombolysis therapy; in the PMCT + CDT group, there were three cases of gastrointestinal bleeding, compared to two cases in the PMCT + CDT + stent group (p = 0.900). Additionally, there was one intracranial hemorrhage in the PMCT + CDT group and two in the PMCT + CDT + stent group. Conclusions: Pharmacomechanical thrombectomy (PMCT) combined with catheter-directed thrombolysis (CDT) therapy has shown significant efficacy in alleviating leg symptoms and reducing the occurrence of post-thrombotic syndrome (PTS), including the incidence of moderate-to-severe PTS. On the other hand, the utilization of PMCT + CDT + stent therapy, tailored to individual patients’ clinical and venous conditions, may enhance long-term venous patency and lead to superior outcomes, including improved quality of life parameters.
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(This article belongs to the Section Cardiovascular Clinical Research)
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Open AccessArticle
The Modified Risk of Paradoxical Embolism Score Is Associated with Patent Foramen Ovale in Patients with Ischemic Stroke: A Nationwide US Analysis
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Chun Shing Kwok, Zaheer Alisiddiq, Maximilian Will, Konstantin Schwarz, Chee Khoo, Adrian Large, Robert Butler, Gregory Y. H. Lip, Adnan I. Qureshi and Josip Andelo Borovac
J. Cardiovasc. Dev. Dis. 2024, 11(7), 213; https://doi.org/10.3390/jcdd11070213 - 5 Jul 2024
Abstract
Background: The Risk of Paradoxical Embolism (RoPE) score was developed to identify stroke-related patent foramen ovale (PFO) in patients with cryptogenic stroke. Methods: We conducted a retrospective analysis of the 2016 to 2020 National Inpatient Sample to determine the performance of the modified
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Background: The Risk of Paradoxical Embolism (RoPE) score was developed to identify stroke-related patent foramen ovale (PFO) in patients with cryptogenic stroke. Methods: We conducted a retrospective analysis of the 2016 to 2020 National Inpatient Sample to determine the performance of the modified RoPE score in identifying the presence of a PFO in patients with acute ischemic stroke (AIS). Results: A total of 3,338,805 hospital admissions for AIS were analysed and 3.0% had PFO. Patients with PFO were younger compared to those without a PFO (median 63 years vs. 71 years, p < 0.001) and fewer were female (46.1% vs. 49.7%, p < 0.001). The patients with PFO had greater mean modified RoPE scores (4.0 vs. 3.3, p < 0.001). The area under the curve for the RoPE score in predicting PFOs was 0.625 (95%CI 0.620–0.629). The best diagnostic power of the RoPE score was achieved with a cut-off point of ≥4 where the sensitivity was 55% and the specificity was 64.2%. A cut-off point of ≥5 increased the specificity (83.1%) at the expense of sensitivity (35.8%). The strongest predictor of PFOs was deep vein thrombosis (OR 3.97, 95%CI 3.76–4.20). Conclusions: The modified RoPE score had modest predictive value in identifying patients with PFO among patients admitted with AIS.
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(This article belongs to the Special Issue Stroke: Risk Factors, Mechanisms, Outcomes and Ethnicity)
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Open AccessArticle
Epidemiological Association of Current Smoking Status with Hypertension and Obesity among Adults Including the Elderly in Korea: Multivariate Analysis of a Nationwide Cross-Sectional Study Excluding Grades 2–3 Hypertension Cases
by
Sung-Eun Park, Seyong Jang, Wi-Young So and Junsu Kim
J. Cardiovasc. Dev. Dis. 2024, 11(7), 212; https://doi.org/10.3390/jcdd11070212 - 5 Jul 2024
Abstract
Smoking is a major global health issue that contributes to various chronic diseases, while hypertension and obesity are considered significant health concerns due to their associated complications, such as cardiovascular diseases and metabolic disorders. In this study, we investigated the associations between current
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Smoking is a major global health issue that contributes to various chronic diseases, while hypertension and obesity are considered significant health concerns due to their associated complications, such as cardiovascular diseases and metabolic disorders. In this study, we investigated the associations between current smoking status, hypertension, and obesity among the Korean population, excluding individuals with high blood pressure (systolic blood pressure ≥ 160 mmHg or diastolic blood pressure ≥ 100 mmHg) and those taking antihypertensive medications. Data from the 2015 Korea National Fitness Assessment, encompassing 3457 individuals, were analyzed. Logistic regression analysis was used to examine the effects of current smoking and other variables on hypertension and obesity. The results showed that, among the population that excludes specific hypertension criteria, current smoking status was not significantly associated with hypertension or obesity. However, sex and body mass index were significantly associated with hypertension, and age, sex, and blood pressure were significantly associated with obesity. Future research should utilize larger sample sizes and longitudinal designs to confirm these findings and include a broader range of hypertensive participants to better control for potential confounding variables.
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(This article belongs to the Special Issue Risk Factors and Prevention of Cardiovascular Diseases)
Open AccessArticle
Elucidating the Relationship between Neutrophil–Lymphocyte Ratio and Plaque Composition in Patients with Drug-Eluting Stent Restenosis by Virtual Histology-Intravascular Ultrasound
by
Ming Yu, Yuxing Wang, Song Yang, Jiajie Mei, Zhenzhu Liu, Lijiao Zhang, Wenli Xie, Zhaohong Geng, Baole Liu, Hongyan Wang, Peng Qu and Nan Niu
J. Cardiovasc. Dev. Dis. 2024, 11(7), 211; https://doi.org/10.3390/jcdd11070211 - 4 Jul 2024
Abstract
(1) Background: In-stent Restenosis (ISR) is a major factor influencing the prognosis and revascularization of target lesions. The plaque composition is unclear; therefore, it is critical to investigate ISR composition to identify clinical intervention markers. (2) Methods: This study was conducted on 36
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(1) Background: In-stent Restenosis (ISR) is a major factor influencing the prognosis and revascularization of target lesions. The plaque composition is unclear; therefore, it is critical to investigate ISR composition to identify clinical intervention markers. (2) Methods: This study was conducted on 36 patients with drug-eluting stent restenosis. The patients were classified into a Low Neutrophil–Lymphocyte Ratio (L-NLR) and High Neutrophil–Lymphocyte Ratio (H-NLR) according to the median NLR level of 36 patients. Discrepancies in the current information such as baseline data, biochemical examination, cardiac ultrasound data, etc., were examined to identify the underlying risk factors, and a multifactorial linear regression analysis of plaque properties was conducted. (3) Results: NLR = 2.64 was utilized to classify 18 patients into the L-NLR group and 18 patients into the H-NLR group. There were statistically significant differences in age, a pre-percutaneous coronary intervention (PCI) SYNTAX II score, a C-reactive protein (CRP), interleukin (IL)-6, plaque loading, a fibro-lipid tissue area, calcified nubs, and virtual histology-thin fibrous cap atherosclerotic (VH-TCFA). The significant impacts of variations in age, neutrophil–lymphocyte ratio (NLR) levels, and IL-6 levels on the plaque stress and percentage of the fibro-lipid tissue in virtual histology-intravascular ultrasound (VH-IVUS) were identified through multifactorial linear regression. (4) Conclusions: The high NLR group demonstrated increased myocardial injury severity, consistent with higher SYNTAX II scores, a higher plaque burden, and higher proportions of vulnerable components. NLR proved to be a risk factor for both the plaque load and the proportion of the fibro-lipid tissue in ISR.
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(This article belongs to the Section Cardiovascular Clinical Research)
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Open AccessArticle
Pre-Existing Atrial Fibrillation in Hospitalized Patients with COVID-19: Insights from the CARDIO COVID 19–20 Registry
by
Wikler Bernal Torres, Juan Pablo Arango-Ibanez, Juan Manuel Montero Echeverri, Santiago Posso Marín, Armando Alvarado, Andrés Ulate, Paola Oliver, Ivan Criollo, Wilbert German Yabar Galindo, Sylvia Sandoval, William Millán Orozco, Fernando Verdugo Thomas, Franco Appiani Florit, Andrés Buitrago, Alejandra Ines Christen, Igor Morr, Luiz Carlos Santana Passos, Marlon Aguirre, Roger Martín Correa, Hoover O. León-Giraldo, Andrea Alejandra Arteaga-Tobar and Juan Esteban Gómez-Mesaadd
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J. Cardiovasc. Dev. Dis. 2024, 11(7), 210; https://doi.org/10.3390/jcdd11070210 - 4 Jul 2024
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Pre-existing (chronic) atrial fibrillation (AF) has been identified as a risk factor for cardiovascular complications and mortality in patients with COVID-19; however, evidence in Latin America (LATAM) is scarce. This prospective and multicenter study from the CARDIO COVID 19–20 database includes hospitalized adults
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Pre-existing (chronic) atrial fibrillation (AF) has been identified as a risk factor for cardiovascular complications and mortality in patients with COVID-19; however, evidence in Latin America (LATAM) is scarce. This prospective and multicenter study from the CARDIO COVID 19–20 database includes hospitalized adults with COVID-19 from 14 countries in LATAM. A parsimonious logistic regression model was used to identify the main factors associated with mortality in a simulated case-control setting comparing patients with a history of AF to those without. In total, 3260 patients were included, of which 115 had AF. The AF group was older, had a higher prevalence of comorbidities, and had greater use of cardiovascular medications. In the model, AF, chronic kidney disease, and a respiratory rate > 25 at admission were associated with higher in-hospital mortality. The use of corticosteroids did not reach statistical significance; however, an effect was seen through the confidence interval. Thus, pre-existing AF increases mortality risk irrespective of other concomitant factors. Chronic kidney disease and a high respiratory rate at admission are also key factors for in-hospital mortality. These findings highlight the importance of comorbidities and regional characteristics in COVID-19 outcomes, in this instance, enhancing the evidence for patients from LATAM.
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Open AccessReview
Remote Monitoring of Cardiac Implantable Electronic Devices in Very Elderly Patients: Advantages and Specific Problems
by
Roberto Scacciavillani, Leonidas Koliastasis, Ioannis Doundoulakis, Sotirios Chiotis, Athanasios Kordalis, Maria Lucia Narducci, Sotiris Kotoulas, Gaetano Pinnacchio, Gianluigi Bencardino, Francesco Perna, Gianluca Comerci, Konstantinos A. Gatzoulis, Dimitris Tsiachris and Gemma Pelargonio
J. Cardiovasc. Dev. Dis. 2024, 11(7), 209; https://doi.org/10.3390/jcdd11070209 - 3 Jul 2024
Abstract
Cardiac implantable electronic devices (CIEDs) offer the benefit of remote monitoring and decision making and find particular applications in special populations such as the elderly. Less transportation, reduced costs, prompt diagnosis, a sense of security, and continuous real-time monitoring are the main advantages.
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Cardiac implantable electronic devices (CIEDs) offer the benefit of remote monitoring and decision making and find particular applications in special populations such as the elderly. Less transportation, reduced costs, prompt diagnosis, a sense of security, and continuous real-time monitoring are the main advantages. On the other hand, less physician–patient interactions and the technology barrier in the elderly pose specific problems in remote monitoring. CIEDs nowadays are abundant and are mostly represented by rhythm control/monitoring devices, whereas hemodynamic remote monitoring devices are gaining popularity and are evolving and becoming refined. Future directions include the involvement of artificial intelligence, yet disparities of availability, lack of follow-up data, and insufficient patient education are still areas to be improved. This review aims to describe the role of CIED in the very elderly and highlight the merits and possible drawbacks.
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(This article belongs to the Special Issue 10th Anniversary of JCDD—Remote Monitoring with Cardiac Implanted Electronic Devices in Electrophysiology and Cardiovascular Physiology)
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Open AccessEditorial
New Pacing Techniques and Non-Invasive Methods That May Improve Response to Cardiac Resynchronization Therapy
by
András Vereckei
J. Cardiovasc. Dev. Dis. 2024, 11(7), 208; https://doi.org/10.3390/jcdd11070208 - 3 Jul 2024
Abstract
Although cardiac resynchronization therapy (CRT) is an evidence-based effective therapy of symptomatic heart failure with reduced ejection fraction (HFrEF), refractory to optimal medical treatment and associated with intraventricular conduction disturbance, the non-response rate to CRT is still around 30% [...]
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(This article belongs to the Special Issue New Pacing Techniques and Non-invasive Methods That May Improve Response and Patient Selection to Cardiac Resynchronization Therapy)
Open AccessArticle
Machine Learning Approaches for Stroke Risk Prediction: Findings from the Suita Study
by
Thien Vu, Yoshihiro Kokubo, Mai Inoue, Masaki Yamamoto, Attayeb Mohsen, Agustin Martin-Morales, Takao Inoué, Research Dawadi and Michihiro Araki
J. Cardiovasc. Dev. Dis. 2024, 11(7), 207; https://doi.org/10.3390/jcdd11070207 - 1 Jul 2024
Abstract
Stroke constitutes a significant public health concern due to its impact on mortality and morbidity. This study investigates the utility of machine learning algorithms in predicting stroke and identifying key risk factors using data from the Suita study, comprising 7389 participants and 53
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Stroke constitutes a significant public health concern due to its impact on mortality and morbidity. This study investigates the utility of machine learning algorithms in predicting stroke and identifying key risk factors using data from the Suita study, comprising 7389 participants and 53 variables. Initially, unsupervised k-prototype clustering categorized participants into risk clusters, while five supervised models including Logistic Regression (LR), Random Forest (RF), Support Vector Machine (SVM), Extreme Gradient Boosting (XGBoost), and Light Gradient Boosted Machine (LightGBM) were employed to predict stroke outcomes. Stroke incidence disparities among identified risk clusters using the unsupervised k-prototype clustering method are substantial, according to the findings. Supervised learning, particularly RF, was a preferable option because of the higher levels of performance metrics. The Shapley Additive Explanations (SHAP) method identified age, systolic blood pressure, hypertension, estimated glomerular filtration rate, metabolic syndrome, and blood glucose level as key predictors of stroke, aligning with findings from the unsupervised clustering approach in high-risk groups. Additionally, previously unidentified risk factors such as elbow joint thickness, fructosamine, hemoglobin, and calcium level demonstrate potential for stroke prediction. In conclusion, machine learning facilitated accurate stroke risk predictions and highlighted potential biomarkers, offering a data-driven framework for risk assessment and biomarker discovery.
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(This article belongs to the Section Stroke and Cerebrovascular Disease)
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Open AccessSystematic Review
Systematic Review on the Role of IL-6 and IL-1β in Cardiovascular Diseases
by
Nurlubek Katkenov, Zhussipbek Mukhatayev, Samat Kozhakhmetov, Aliya Sailybayeva, Makhabbat Bekbossynova and Almagul Kushugulova
J. Cardiovasc. Dev. Dis. 2024, 11(7), 206; https://doi.org/10.3390/jcdd11070206 - 1 Jul 2024
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Cardiovascular diseases (CVDs) are a leading cause of global morbidity and mortality, significantly driven by chronic inflammation. Interleukin-6 (IL-6) and interleukin-1β (IL-1β) are critical inflammatory cytokines implicated in CVD progression. This systematic review evaluates the roles of IL-6 and IL-1β in CVDs by
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Cardiovascular diseases (CVDs) are a leading cause of global morbidity and mortality, significantly driven by chronic inflammation. Interleukin-6 (IL-6) and interleukin-1β (IL-1β) are critical inflammatory cytokines implicated in CVD progression. This systematic review evaluates the roles of IL-6 and IL-1β in CVDs by synthesizing data from relevant studies to understand their impact on cardiovascular outcomes and identify potential therapeutic interventions. A comprehensive literature search was conducted using PubMed and Embase, covering studies from January 2014 to December 2024. Inclusion criteria encompassed studies investigating IL-6 and/or IL-1β in CVDs, including human and relevant animal models, and reporting clinical outcomes, molecular mechanisms, or therapeutic interventions. Data extraction and quality assessment were performed independently by two reviewers. Our review included 12 studies focusing on the roles of IL-6 and IL-1β in various CVDs. Elevated IL-6 levels were significantly associated with peripheral artery disease, myocardial infarction, and heart failure, while IL-1β levels were linked to worse outcomes in coronary artery disease and heart failure. Meta-analyses indicated a significant association between higher IL-6 and IL-1β levels and increased risk of adverse cardiovascular events. These findings suggest that targeting IL-6 and IL-1β could offer promising therapeutic strategies for reducing inflammation and improving cardiovascular outcomes.
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Open AccessArticle
Association of Abnormal Cardiac Biomarkers and Cardiovascular Complications, with Mortality in Patients with SARS-CoV-2 Infection in Latin America
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Juan Esteban Gómez-Mesa, Manuela Escalante, Juan Andrés Muñoz-Ordoñez, Valeria Azcárate-Rodriguez, Juan David Peláez-Martínez, Andrea Alejandra Arteaga-Tobar, Hoover León-Giraldo, Andrea Valencia-Orozco, Eduardo Roque Perna, Alexander Romero, Iván Mendoza, Fernando Wyss, José Luis Barisani, Mario Speranza, Walter Alarco, Cesar Herrera, Julián Lugo-Peña, Liliana Patricia Cárdenas-Aldaz, Victor Rossel and Daniel Sierra
J. Cardiovasc. Dev. Dis. 2024, 11(7), 205; https://doi.org/10.3390/jcdd11070205 - 30 Jun 2024
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Background: The COVID-19 pandemic has highlighted a correlation between cardiac complications and elevated cardiac biomarkers, which are linked to poorer clinical outcomes. Objective: This study aims to determine the clinical impact of cardiac biomarkers in COVID-19 patients in Latin America. Subjects and methods:
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Background: The COVID-19 pandemic has highlighted a correlation between cardiac complications and elevated cardiac biomarkers, which are linked to poorer clinical outcomes. Objective: This study aims to determine the clinical impact of cardiac biomarkers in COVID-19 patients in Latin America. Subjects and methods: The CARDIO COVID 19-20 Registry is a multicenter observational study across 44 hospitals in Latin America and the Caribbean. It included hospitalized COVID-19 patients (n = 476) who underwent troponin, natriuretic peptide, and D-dimer tests. Patients were grouped based on the number of positive biomarkers. Results: Among the 476 patients tested, 139 had one positive biomarker (Group C), 190 had two (Group B), 118 had three (Group A), and 29 had none (Group D). A directly proportional relationship was observed between the number of positive biomarkers and the incidence of decompensated heart failure. Similarly, there was a proportional relationship between the number of positive biomarkers and increased mortality. In Group B, patients with elevated troponin and natriuretic peptide and those with elevated troponin and D-dimer had 1.4 and 1.5 times higher mortality, respectively, than those with elevated natriuretic peptide and D-dimer. Conclusions: In Latin American COVID-19 patients, a higher number of positive cardiac biomarkers is associated with increased cardiovascular complications and mortality. These findings suggest that cardiac biomarkers should be utilized to guide acute-phase treatment strategies.
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Open AccessReview
Impact of Obstructive Sleep Apnea and Sympathetic Nervous System on Cardiac Health: A Comprehensive Review
by
Antonino Maniaci, Salvatore Lavalle, Federica Maria Parisi, Marco Barbanti, Salvatore Cocuzza, Giannicola Iannella, Giuseppe Magliulo, Annalisa Pace, Mario Lentini, Edoardo Masiello and Luigi La Via
J. Cardiovasc. Dev. Dis. 2024, 11(7), 204; https://doi.org/10.3390/jcdd11070204 - 30 Jun 2024
Abstract
A prevalent condition linked to an elevated risk of cardiovascular disease is sleep apnea. This review examines the connections between cardiac risk, the sympathetic nervous system, and sleep apnea. The increased risk of hypertension, arrhythmias, myocardial infarction, and heart failure was highlighted in
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A prevalent condition linked to an elevated risk of cardiovascular disease is sleep apnea. This review examines the connections between cardiac risk, the sympathetic nervous system, and sleep apnea. The increased risk of hypertension, arrhythmias, myocardial infarction, and heart failure was highlighted in the pathophysiology of sleep apnea and its effect on sympathetic activation. It is also important to consider potential processes such as oxidative stress, inflammation, endothelial dysfunction, and autonomic imbalance that may relate sleep apnea-induced sympathetic activation to cardiac risk. With implications for creating innovative diagnostic and treatment approaches to lessen the cardiovascular effects of sleep apnea, the goal of this investigation is to improve the understanding of the intricate link between sympathetic activity, cardiac risk, and sleep apnea. This study aimed to clarify the complex relationship between cardiovascular health and sleep apnea by synthesizing the available research and highlighting the crucial role played by the sympathetic nervous system in moderating this relationship. Our thorough investigation may have important therapeutic ramifications that will direct the creation of focused therapies to enhance cardiovascular outcomes in sleep apnea sufferers.
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(This article belongs to the Special Issue Cardiovascular Disease: Risk Factors and Prevention)
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Open AccessReview
Potential Role of Left Atrial Strain to Predict Atrial Fibrillation Recurrence after Catheter Ablation Therapy: A Clinical and Systematic Review
by
Maria Barilli, Giulia Elena Mandoli, Nicolò Sisti, Aleksander Dokollari, Nicolò Ghionzoli, Hatem Soliman-Aboumarie, Flavio D’Ascenzi, Marta Focardi, Luna Cavigli, Maria Concetta Pastore and Matteo Cameli
J. Cardiovasc. Dev. Dis. 2024, 11(7), 203; https://doi.org/10.3390/jcdd11070203 - 30 Jun 2024
Abstract
Pulmonary vein isolation (PVI) with catheter ablation (CA) represents an effective therapy for atrial fibrillation (AF). Unfortunately, it is still not exempt from severe complications. The balance of risks and benefits should be assessed, and a patient-tailored approach is desirable. So far, several
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Pulmonary vein isolation (PVI) with catheter ablation (CA) represents an effective therapy for atrial fibrillation (AF). Unfortunately, it is still not exempt from severe complications. The balance of risks and benefits should be assessed, and a patient-tailored approach is desirable. So far, several clinical and cardiac imaging parameters have been evaluated to investigate pre- and post-procedural features that could help clinicians in the selection of patients at high risk of a poor outcome after CA. This clinical and systematic review analyses the potential role of new LA parameters, such as LA reservoir strain, to predict AF recurrence after CA therapy. Notably, LA reservoir strain gains substantial clinical importance in patients with paroxysmal AF and when a low CHADS2-VASc score is retrieved. LA reservoir strain provides data concerning the risk of AF recurrence after PVI and, thus, in the management of long-term medical therapy in this patient’s group.
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(This article belongs to the Special Issue Feature Review Papers in Imaging)
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Open AccessArticle
Prognostic Value of Serum Galectin-3 for Survival in Patients with Cardiac Light-Chain Amyloidosis
by
Xinglin Yang, Jin Huang, Jinghong Zhang, Jian Li and Zhuang Tian
J. Cardiovasc. Dev. Dis. 2024, 11(7), 202; https://doi.org/10.3390/jcdd11070202 - 29 Jun 2024
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Background: Amyloid light-chain (AL) amyloidosis is a multisystem disorder, with cardiac amyloid infiltration being a prevalent manifestation. This study aimed to explore the prognostic value of galectin-3 (Gal-3), a soluble marker associated with fibrosis, inflammation, heart failure, and kidney injury, in patients with
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Background: Amyloid light-chain (AL) amyloidosis is a multisystem disorder, with cardiac amyloid infiltration being a prevalent manifestation. This study aimed to explore the prognostic value of galectin-3 (Gal-3), a soluble marker associated with fibrosis, inflammation, heart failure, and kidney injury, in patients with cardiac AL amyloidosis. Methods: A total of 60 patients who were diagnosed with cardiac AL amyloidosis from January 2015 to May 2018 were enrolled. The prognostic value of Gal-3 was assessed. Receiver operating characteristic (ROC) curves were used to evaluate the predictive accuracy of Gal-3. A Gal-3 cut-off value was identified to predict survival rates. Results: The ROC curves demonstrated a moderate predictive accuracy of Gal-3 for 0.5- and 5-year survival, with area under the curve (AUC) values of 0.722 and 0.788, respectively. A Gal-3 cut-off value of 15.154 ng/mL was found to predict survival. Kaplan–Meier survival analysis revealed a significant difference in mean overall survival between patients with Gal-3 levels below and above the established cut-off (69.2 months versus 42.1 months, respectively; p = 0.036). Multivariate analysis confirmed that Gal-3 > 15.154 ng/mL remained an independent predictor of survival (HR 2.451, 95% CI 1.017–5.910, p = 0.046). Conclusions: This study suggests that Gal-3 holds independent prognostic value for survival in patients with cardiac AL amyloidosis. Gal-3 could potentially enhance the prognostic capabilities of the current soluble markers, thereby improving the management of cardiac AL amyloidosis. However, further validation in larger prospective studies is warranted.
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Open AccessArticle
Ten-Year Experience with a Transapical Approach for Transcatheter Aortic and Mitral Valve Implantation
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Antonella Galeone, Fabiola Perrone, Gabriele Pesarini, Flavio Luciano Ribichini, Renato Di Gaetano, Giovanni Battista Luciani and Francesco Onorati
J. Cardiovasc. Dev. Dis. 2024, 11(7), 201; https://doi.org/10.3390/jcdd11070201 - 29 Jun 2024
Abstract
Background: The transfemoral approach represents the optimal access for TAVI due to its low invasiveness; however, up to 10–15% of TAVI candidates are considered unsuitable for femoral access because of significant peripheral vascular disease and need alternative access. Methods: This is a single-center
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Background: The transfemoral approach represents the optimal access for TAVI due to its low invasiveness; however, up to 10–15% of TAVI candidates are considered unsuitable for femoral access because of significant peripheral vascular disease and need alternative access. Methods: This is a single-center retrospective observational study including all consecutive adult patients undergoing transcatheter procedures through a TA approach from March 2015 to April 2024. Results: 213 patients underwent transcatheter aortic or mitral valve implantation through a TA approach and were enrolled in this study. The mean age of the patients was 79.5 ± 5.7 years, and 54% of the patients were males. The mean Euroscore II was 7.9 ± 6.4%. One-third of the patients had previous cardiac surgery. The overall mean survival time was 5.3 ± 0.3 years. Nine (4%) patients developed infective endocarditis (IE) during the follow-up. Conclusions: The transapical approach for transcatheter procedures is a safe and effective procedure for patients unsuitable for TF access with low periprocedural mortality and a low rate of post-procedural complications when performed by experienced surgeons and cardiologists.
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(This article belongs to the Special Issue Transcatheter Aortic Valve Implantation (TAVI) II)
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Open AccessCase Report
Ventricular Fibrillation during Optical Coherence Tomography
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Paula Vela Martín, Carlos Arellano Serrano, Álvaro Lorente Ros, Juan Francisco Oteo and Arturo Garcia-Touchard
J. Cardiovasc. Dev. Dis. 2024, 11(7), 200; https://doi.org/10.3390/jcdd11070200 - 29 Jun 2024
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Optical Coherence Tomography (OCT) imaging is a valuable tool for complex coronary interventions. While complications are rare, the occurrence of ventricular arrhythmias during its use is one of the most feared. Unfortunately, the mechanism by which these arrhythmias arise remains unclear. We describe
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Optical Coherence Tomography (OCT) imaging is a valuable tool for complex coronary interventions. While complications are rare, the occurrence of ventricular arrhythmias during its use is one of the most feared. Unfortunately, the mechanism by which these arrhythmias arise remains unclear. We describe the case of a patient under continuous electrocardiographic (ECG) monitoring who experienced ventricular fibrillation during an OCT procedure. A detailed analysis of the ECG event sequence was performed, from the administration of the contrast medium to the onset of ventricular fibrillation. Utilizing the collected data, we examined potential precipitating factors based on the observed alterations in the electrocardiogram. A comprehensive understanding of the mechanisms underlying these arrhythmias is crucial for the development of preventive measures that avoid such incidents in the future.
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