Current Cardiology Reviews - Volume 21, Issue 1, 2025
Volume 21, Issue 1, 2025
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Hot Water Immersion as a Means to Prevent Cardiovascular Disease and Associated Mortality
Authors: Metodija Kjertakov and Aaron PetersenPhysical activity is widely promoted as a preventive strategy against cardiovascular disease and death from this disease. However, the fact that some individuals are unable or unwilling to engage in physical activity highlights the need for alternative strategies. Passive heat exposure using hot water immersion could serve as an alternative to physical exercise, as it provides similar, if not greater, cardioprotection than physical activity. This perspective article presents evidence supporting our concept and provides recommendations for hot water immersion sessions.
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The Relationship between Using Renin-Angiotensin System Inhibitors with Mortality of Atrial Fibrillation: A Systematic Review and Meta-Analysis
BackgroundAtrial fibrillation (AFib) is a highly prevalent cardiac arrhythmia associated with increased mortality in affected persons. Renin-angiotensin system inhibitors (RASIs) have been suggested as potential therapeutic agents for cardiovascular and renal diseases.
ObjectivesHowever, the relationship between RASIs and mortality in AFib patients remains uncertain. Therefore, the present study was designed and implemented for this purpose.
MethodsWe searched PubMed/MEDLINE, Embase, Web of Science (WOS), Cochrane Library, and Scopus databases for studies published until 12 February 2024 with relevant keywords. We included studies that reported mortality outcomes in AFib patients treated with RASIs and non-users. The data extraction and quality assessment processes were conducted, and subgroup analyses and sensitivity analyses were done. The data were analyzed by Stata 15 using statistical tests, such as Chi-square and I2 tests.
ResultsA total of 15 studies (2007-2024; n=2,178,565 patients) examined the association between RASI drugs and mortality of patients with AFib. The results indicated that compared to the control group, the odds of AFib mortality in the group receiving RASIs were equal to 0.81(95% CI: 0.71-0.92; P-value ≤0.001). The study results did not indicate publication bias (P-value=0.733). During the meta-regression analysis, none of the study variables demonstrated a significant relationship with the observed heterogeneity (P-value > 0.20). Cumulative OR results showed that from 2022 onwards, there was enough evidence to confirm the relationship using RASIs with mortality of patients with AFib.
ConclusionTherefore, this meta-analysis suggests that the use of RASI drugs is associated with reduced AFib mortality. However, the authors emphasize the need for further high-quality studies and large-scale randomized clinical trials to validate these findings.
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A Systematic Review on the Effectiveness of Machine Learning in the Detection of Atrial Fibrillation
Recent endeavors have led to the exploration of Machine Learning (ML) to enhance the detection and accurate diagnosis of heart pathologies. This is due to the growing need to improve efficiency in diagnostics and hasten the process of delivering treatment. Several institutions have actively assessed the possibility of creating algorithms for advancing our understanding of atrial fibrillation (AF), a common form of sustained arrhythmia. This means that artificial intelligence is now being used to analyze electrocardiogram (ECG) data. The data is typically extracted from large patient databases and then subsequently used to train and test the algorithm with the help of neural networks. Machine learning has been used to effectively detect atrial fibrillation with more accuracy than clinical experts, and if applied to clinical practice, it will aid in early diagnosis and management of the condition and thus reduce thromboembolic complications of the disease. In this text, a review of the application of machine learning in the analysis and detection of atrial fibrillation, a comparison of the outcomes (sensitivity, specificity, and accuracy), and the framework and methods of the studies conducted have been presented.
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Advancements in Cardiac Catheterization Safety: Novel Radiation Protection Approaches Redefining Occupational Health
Authors: Zahra Shaghaghi, Roozbeh Narimani Javid and Maryam AlvandiRadiation exposure poses a substantial occupational risk for healthcare professionals in the catheterization laboratory (cath lab). The escalating complexity and frequency of interventional procedures, such as cardiac catheterizations and percutaneous coronary interventions, underscore the need for innovative strategies to mitigate radiation exposure. While traditional measures like lead aprons, thyroid collars, and goggles have been pivotal in reducing radiation exposure, they have limitations, especially during prolonged and intricate procedures. Consequently, there is a growing demand for advanced radiation protection methods that prioritize safety without compromising procedural efficacy. Recent strides in radiation protection technology have given rise to novel shielding devices and zero-radiation approaches tailored for cath lab use. The novel shields leverage innovative materials and designs to achieve superior attenuation of both scattered and direct radiation. Their ergonomic and adjustable features also ensure optimal shielding coverage without impeding the operator's skill or workflow. Multiple studies have validated the effectiveness of these advanced radiation protection methods in diminishing occupational radiation exposure in the cath lab. Initial findings suggest a significant reduction in doses for operators and staff, potentially lowering the risk of radiation-induced health complications over the long term. This article provides a comprehensive review of the current landscape of radiation protection shields in the cath lab, emphasizing the efficacy and potential of these cutting-edge shielding technologies.
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Use of Herbal Drugs in Cardiovascular Disease- A Review
Authors: Arshdeep Kaur and Ranjeet KumarThirty percent of deaths worldwide are caused by cardiovascular disorders (CVDs). As per the WHO data, the number of fatalities due to CVDs is 17.9 million years, and it is projected to cause 22.2 million deaths by 2030. In terms of gender, women die from CVD at a rate of 51% compared to 42% for males. Most people use phytochemicals, a type of traditional medicine derived from plants, either in addition to or instead of commercially available medications to treat and prevent CVD. Phytochemicals are useful in lowering cardiovascular risks, especially for lowering blood cholesterol, lowering obesity-related factors, controlling blood sugar and the consequences of type 2 diabetes, controlling oxidative stress factors and inflammation, and preventing platelet aggregation. Medicinal plants that are widely known for treating CVD include ginseng, Ginkgo biloba, ganoderma lucidum, gynostemma pentaphyllum, viridis amaranthus, etc. Plant sterol, flavonoids, polyphenols, sulphur compound and terpenoid are the active phytochemicals present in these plants. The aim of this article is to cover more and more drugs that are used for cardiovascular diseases. In this article, we will learn about the use of different herbal drugs, mechanism of action, phytochemical compounds, side effects, etc. However, more research is required to comprehend the process and particular phytochemicals found in plants that treat CVD.
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Incidence of Infective Endocarditis Post-TPVR with MELODY Valve in Pediatric Patients: A Systematic Review and Meta-Analysis
IntroductionInfective Endocarditis (IE) has emerged to be one of the most impactful adverse complications post-transcatheter procedures, especially Transcatheter Pulmonary Valve Replacement (TPVR). We conducted a systematic review and meta-analysis with the aim of identifying the incidence of IE post-TPVR with the MELODY valve in the pediatric population.
MethodsA comprehensive literature search was performed across several prominent databases, including PubMed/MEDLINE, SCOPUS, and Science Direct. Studies compared the clinical outcomes of pediatric patients who received TPVR using the MELODY valve. Data extraction was done for variables like the total pediatric patient population that underwent TPVR with MELODY valve, mean age, the sex of the patients, the incidence rate of IE following the procedure, and the duration between the procedure and the occurrence of IE. Inverse Variance was used to estimate the incidence of IE in patients who underwent TPVR with respective 95% confidence interval (CI).
ResultsIn total, 4 studies with 414 pediatric patients who underwent TPVR using the MELODY valve were included in the study. The mean age of the study population was 12.7 ± 3.11 years. The pooled incidence of IE following TPVR with MELODY valve in the pediatric population was 17.70% (95% Cl 3.84-31.55; p<0.00001). Additionally, the mean length of duration to develop IE following TPVR with MELODY valve in the pediatric population was 2.18 years (95% Cl 0.35-4.01; p<0.00001).
ConclusionOur meta-analysis reveals that IE post-TPVR with MELODY valve in pediatric patients is a significant complication, clinically and statistically. Further research needs to be done to understand the risk factors and develop better management strategies.
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The Impact of Beta-Blocker Maintenance on Decompensated Heart Failure: A Systematic Review and Meta-Analysis
BackgroundAcute Heart Failure (HF) is related to a significant hospital mortality rate and functional impairment in many patients. However, there is still a lack of studies that support the use of Beta-blockers (BB) in the management of decompensated HF. Objective: This study aimed to evaluate the impact on mortality of maintaining BB in patients with decompensated HF.
MethodsA systematic review and meta-analysis was performed, using the databases PubMed, Cochrane Library, SCIELO and BVS, selecting only cohort studies and Randomized Clinical Trials (RCTs) from the last 10 years, which have been selected based on inclusion and exclusion criteria.
ResultsAn 86% reduction in the risk of in-hospital death was found (RR=0.14, 95% CI: 0.10-0.18) in patients with HF who maintained the use of BB during hospitalization. A second analysis found a 44% (RR=0.56, 95% CI: 0.47-0.66) lower chance of in-hospital death in the group that previously used BB. Regarding the analysis of mortality after hospital discharge, only studies that have evaluated the use of BB in HF with reduced ejection fraction pointed to a reduction in mortality. Furthermore, some articles have found a relationship between the reduction in readmissions and the use of post-discharge BB.
ConclusionThere is still no consensus regarding the use of BB in patients hospitalized with decompensated HF. In view of the limitations of the data found in the present study, the need for more RCTs that address this topic is emphasized in order to resolve this uncertainty in the management of cardiovascular patients.
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A Contemporary Review on Heart Failure with Preserved Ejection Fraction: Epidemiology, Diagnosis, and Management
Authors: Mahek Shahid, Ramzi Ibrahim, Abdulbaril Olagunju, Martina Mookadam and Farouk MookadamHeart failure with preserved ejection fraction (HFpEF) includes almost half of heart failure cases typified by a specific clinical syndrome. Despite diagnostic and management advances, HFpEF still presents a diagnostic challenge and a paucity of therapies specifically aimed at enhancing survival and improving quality of life is still lacking. This review elucidates the diagnostic complexity of HFpEF, highlighting the use of both subjective and objective criteria within algorithmic frameworks. It also examines the significant impact of comorbidities on the progression of HFpEF. Additionally, we explore the latest evidence on targeting these comorbidities therapeutically, although the benefits to mortality are still limited.
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Non-rodent Models of Atherosclerosis: Repurposing of Existing Drugs and Search for Novel Treatment Strategies
Atherosclerosis and associated cardiovascular diseases are the leading causes of illness and mortality worldwide. The development of atherosclerosis is a complex process involving oxidative stress, surplus lipid deposition and retention, endothelial dysfunction, and chronic inflammation. Developing novel anti-atherogenic and repurposing existing drugs requires the use of suitable animal models to characterise the fundamental mechanisms underlying atherosclerosis initiation and progression and to evaluate potential therapeutic effects. Commonly used rodent models, however, are not always appropriate, and other models may be required to translate these discoveries into valuable preventive and treatment agents for human applications. Recent advances in gene-editing tools for large animals have allowed the creation of animals that develop atherosclerosis faster and more similarly to humans in terms of lesion localisation and histopathology. In this review, we discuss the major advantages and drawbacks of the main non-rodent animal models of atherosclerosis, particularly rabbits, pigs, zebrafish, and non-human primates. Moreover, we review the application of recently invented novel therapeutic methods and agents, and repurposed existing drugs (such as antidiabetic and anticancer) for atherosclerosis treatment, the efficacy of which is verified on non-rodent animal models of atherosclerosis. In total, the proper selection of a suitable animal model of atherosclerosis facilitates reproducible and rigorous translational research in repurposing of existing drugs, discovering new therapeutic strategies, and validating novel anti-atherosclerotic drugs.
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Insulin Resistance, Hyperinsulinemia and Atherosclerosis: Insights into Pathophysiological Aspects and Future Therapeutic Prospects
Insulin resistance describes the lack of activity of a known quantity of insulin (exogenous or endogenous) to promote the uptake of glucose and its utilization in an individual, as much as it does in metabolically normal individuals. On the cellular level, it suggests insufficient power of the insulin pathway (from the insulin receptor downstream to its final substrates) that is essential for multiple mitogenic and metabolic aspects of cellular homeostasis. Atherosclerosis is a slow, complex, and multifactorial pathobiological process in medium to large arteries and involves several tissues and cell types (immune, vascular, and metabolic cells). Inflammatory responses and immunoregulation are key players in its development and progression. This paper examines the possible pathophysiological mechanisms that govern the connection of insulin resistance, hyperinsulinemia, and the closely associated cardiometabolic syndrome with atherosclerosis, after exploring thoroughly both in vitro and in vivo (preclinical and clinical) evidence. It also discusses the importance of visualizing and developing novel therapeutic strategies and targets for treatment, to face this metabolic state through its genesis.
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Volumes & issues
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Volume 21 (2025)
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Volume 20 (2024)
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Volume 19 (2023)
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Volume 18 (2022)
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Volume 17 (2021)
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Volume 16 (2020)
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Volume 15 (2019)
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Volume 14 (2018)
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Volume 13 (2017)
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Volume 12 (2016)
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Volume 11 (2015)
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Volume 10 (2014)
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Volume 9 (2013)
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Volume 8 (2012)
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Volume 7 (2011)
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Volume 6 (2010)
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Volume 5 (2009)
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Volume 4 (2008)
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Volume 3 (2007)
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Volume 2 (2006)
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Volume 1 (2005)
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