Agregador de feeds

JACC Case Rep. 2025 Jun 18;30(15):103679. doi: 10.1016/j.jaccas.2025.103679.

ABSTRACT

Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial infarction, distinctly from atherosclerotic disease. Conservative management is typically recommended, but the incidence of mechanical complications is poorly defined, with only 7 cases reported. We describe a 62-year-old woman with SCAD complicated by left ventricular free wall rupture. Despite initial conservative management, she developed in-hospital cardiac arrest just moments before discharge and was treated with extracorporeal membrane oxygenation (ECMO), stabilizing her condition and enabling emergency surgical repair. This case underscores the potential role of ECMO in managing SCAD with life-threatening complications and underscores the need for a tailored approach to the management of SCAD patients, which differ from classical atherosclerotic myocardial infarction.

PMID:40541339 | PMC:PMC12198654 | DOI:10.1016/j.jaccas.2025.103679

J Cardiothorac Vasc Anesth. 2025 May 29:S1053-0770(25)00440-9. doi: 10.1053/j.jvca.2025.05.053. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare the analgesic efficacy of superficial parasternal intercostal plane (S-PIP) block and deep parasternal intercostal plane (D-PIP) to determine which technique provides superior pain relief in cardiac surgery.

DESIGN: A systematic search of MEDLINE (via PubMed), Scopus, Embase, Cochrane Library, Web of Science, Google Scholar, and ClinicalTrials.gov from inception until January 18, 2025. Eligible studies included randomized controlled trials (RCTs) and observational studies that compared the S-PIP and D-PIP blocks in patients undergoing cardiac surgery. The primary outcome of the study was postoperative opioid consumption of morphine milligram equivalent (MME) at 24 hours. Secondary outcomes included resting and movement pain scores at 0, 6, 12 and 24 hours, time to first analgesics, incidence of postoperative nausea and vomiting (PONV), extubation time, length of stay (LOS) in the intensive care unit (ICU), and the number of patients requiring rescue analgesics.

MAIN RESULTS: Seven RCTs and 1 observational study, including a total of 510 patients, were identified. The findings demonstrated no statistically significant difference in MME at 24 hours between the S-PIP and D-PIP block groups (mean difference, -1.23; 95% confidence interval, -2.51 to 0.05; p = 0.061). Additionally, there were no significant differences in pain scores, PONV incidence, time to rescue analgesics, extubation time, or ICU LOS of stay between the 2 techniques.

CONCLUSIONS: S-PIP and D-PIP blocks provide comparable postoperative analgesic efficacy in patients undergoing cardiac surgery.

PMID:40541472 | DOI:10.1053/j.jvca.2025.05.053

Korean J Anesthesiol. 2025 Jun 20. doi: 10.4097/kja.24901. Online ahead of print.

ABSTRACT

BACKGROUND: Sugammadex reverses the effects of steroidal neuromuscular-blocking agents, such as rocuronium, by encapsulating these agents. Its cardiovascular adverse effects include QTc prolongation, hypotension, bradycardia, atrioventricular block, atrial fibrillation, and asystole. Additionally, rocuronium has cardiac side effects, such as bradycardia, hypotension, cardiac arrest, circulatory collapse, and ventricular fibrillation. Herein, we investigated the effects of sugammadex, rocuronium, and combined rocuronium + sugammadex on cardiac electrophysiological parameters.

METHODS: In vitro experiments were performed using ventricular myocytes obtained from male Wistar rats. Myocyte contraction and relaxation responses were recorded along with action potential (AP), and L-type calcium (ICaL) and potassium channel currents (Ito, Iss, and IK1).

RESULTS: Sugammadex caused dose-dependent decreases in myocyte contraction and relaxation responses. Rocuronium had no effect in this respect, whereas its co-administration with sugammadex led to decreased contraction responses. Sugammadex prolonged the AP repolarization phase, whereas rocuronium prolonged all AP phases. Co-administration of sugammadex and rocuronium did not significantly affect AP parameters. Sugammadex suppressed the peak ICaL value, while rocuronium caused an even greater decrease. Co-administration of these drugs further decreased the current-voltage characteristics of the ICaL. However, no significant effects were observed on the potassium currents.

CONCLUSIONS: Separate or combined administration of sugammadex and rocuronium had various effects on myocyte contractility, AP, and ICaL, which could cause significant changes leading to adverse cardiac events. Further experimental and clinical studies are required to understand the clinical consequences of the modulatory effects of these drugs on cardiac electrophysiological parameters.

PMID:40538088 | DOI:10.4097/kja.24901

Eur J Pediatr. 2025 Jun 20;184(7):430. doi: 10.1007/s00431-025-06274-7.

ABSTRACT

This systematic review and meta-analysis aimed to evaluate the clinical outcomes of cardiac surgery in neonates with trisomy 13 (T13) or trisomy 18 (T18) compared to those managed with palliative care. A literature search was conducted in PubMed® and EMBASE®, following PRISMA guidelines, and included five retrospective cohort studies (1627 patients). Outcomes analyzed included in-hospital mortality, survival at 12 months, length of stay (LOS), hospital discharge rates, and the need for mechanical ventilation. The meta-analysis showed that cardiac surgery significantly reduced the odds of in-hospital mortality (OR 0.12, CI 95% 0.03-0.42, p < 0.01), increased survival at 12 months (OR 19.77, CI 95% 5.12-76.36, p < 0.01), and improved discharge rates (OR 12.53, CI 95% 3.63-43.22, p < 0.01). However, limited data were available on quality of life and mechanical ventilation duration. Conclusion: Despite the positive impact of cardiac surgery on survival and discharge rates, the evidence remains low quality, as the included studies were primarily retrospective cohorts with moderate risk of bias. The findings highlight the importance of involving families in the decision-making process, given their differing perspectives on quality of life. Further high-quality studies, such as randomized controlled trials, are needed to provide stronger evidence on this topic.

PMID:40537699 | DOI:10.1007/s00431-025-06274-7

Cardiol Young. 2025 May;35(5):1082-1084. doi: 10.1017/S1047951125001751. Epub 2025 Jun 20.

ABSTRACT

Staged Fontan pathway treatment is a recognised surgical approach for managing congenital heart lesions with single ventricle physiology. Some patients necessitate communication between the tunnel and the atrium to maintain circulatory balance. During follow-up, adjustments to fenestration size may be required. While methods for enlarging or completely closing fenestrations are common, partially reducing flow through a fenestration remains challenging. We present an effective technique for partially reducing the size of a large, stented fenestration using a coronary stent and a vascular occluder.

PMID:40537442 | DOI:10.1017/S1047951125001751

Korean Circ J. 2025 May 14. doi: 10.4070/kcj.2024.0318. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Rotational atherectomy (RA) is a technique used to ablate calcified plaques. There is speculation that operators' experience with RA could play a role in the outcomes.

METHODS: From December 2015 to April 2020, patients with calcified coronary lesions requiring percutaneous coronary intervention (PCI) with RA were enrolled in a prospective, multicenter, observational registry. The patients were divided into two groups based on the number of RAs performed by their operator in the past. A propensity score matching was done for a sensitivity analysis. The primary outcome was a composite of cardiac death, myocardial infarction, and target vessel revascularization at 1 year.

RESULTS: A total of 497 patients were enrolled in the study. The calculated cutoff number of RA-PCI between the two groups was 82 cases. The more experienced group underwent PCI with less fluoroscopy time (less experienced vs. more experienced, 38.8 vs. 30.0 minutes, p<0.001), and more frequent intravascular imaging (54.6% vs. 69.0%, p=0.012). The primary outcome did not differ significantly between the groups (5.2% vs. 7.3%, hazard ratio, 1.46; 95% confidence interval [CI], 0.57-3.74; p=0.433). No significant difference in the incidence of complications was observed between the groups (5.5% vs. 7.0%, odds ratio, 1.38; 95% CI, 0.57-3.04; p=0.526). Similar results were observed in the propensity-score matched population.

CONCLUSIONS: In PCI using RA for calcified lesions, the composite outcome of cardiac death, myocardial infarction, and target vessel revascularization at 1 year was not significantly different according to RA experience among operators.

PMID:40537426 | DOI:10.4070/kcj.2024.0318

Cardiovasc Revasc Med. 2025 Jun 8:S1553-8389(25)00291-X. doi: 10.1016/j.carrev.2025.06.006. Online ahead of print.

ABSTRACT

Current guidelines recommend 6-12 months of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention(PCI) followed by aspirinin monotherapy indefinitely. We aimed to assess efficacy and safety of Clopidogrel as compared to aspirin in patients undrgoing PCI after completing DAPT. We systematically searched 3 electronic databases and identified studies comparing clopidogrel to aspirin in post PCI population after completing DAPT. We included 7 studies with 20,360 patients. We pooled outcomes for major adverse cardiac events (MACE), typically comprising a composite of death, myocardial infarction (MI), or stroke; all-cause mortality; cardiac death; major bleeding; any stroke; ischemic stroke; hemorrhagic stroke; repeat revascularization; target-vessel revascularization (TVR); and definite stent thrombosis. Mean follow up was 12-36 months. Duration of DAPT was 1-18 months. Clopidogrel was associated with reductions in MACE than aspirin (RR: 0.82; 95 % CI: 0.69-0.98; p = 0.03), showed reduced risk of MI (RR 0.93 CI 0.60-1.44; p 0.74, I2 63%) indicating a relative reduction of 7 %, reduced strokes numerically but non-significantly (RR: 0.72; 95 % CI: 0.48-1.07; p = 0.11), RRR 28 %, all cause mortality did not exhibit a significant difference between clopidogrel and aspirin (RR: 0.99; 95 % CI: 0.67-1.44; p = 0.94). Cardiac death (RR: 0.81; 95 % CI: 0.56-1.17; p = 0.26), major bleeding (RR: 0.90; 95 % CI: 0.61-1.33; p = 0.61), reflecting a 10 % non-significant relative reduction, repeat revascularization showed no significant difference (RR: 0.95; 95 % CI: 0.74-1.23; p = 0.72) representing a slight 5 % relative reduction, target vessel revascularization did not reveal any significant differences (RR: 0.89; 95 % CI: 0.69-1.16; p = 0.40) corresponding to a non-significant relative risk reduction of 11 %, stent thrombosis demonstrated no statistically significant difference (RR: 0.78; 95 % CI: 0.27-2.31; p = 0.66) RRR of 22 %. Compared to aspirin Clopidogrel was associated with reduction in MACE with no significant differences in Mortality, Major bleeding, MI, and repeat revascularization between groups. PROSPERO REGISTRATION NUMBER: CRD420251042349.

PMID:40537309 | DOI:10.1016/j.carrev.2025.06.006

Curr Cardiol Rep. 2025 Jun 19;27(1):96. doi: 10.1007/s11886-025-02249-0.

ABSTRACT

PURPOSE OF REVIEW: To provide an overview of up-to-date treatment practices for in-stent restenosis (ISR).

RECENT FINDINGS: ISR is treated with similar effectiveness by paclitaxel drug coated balloons and second-generation drug eluting stents. Sirolimus coated balloons are an emerging technology that requires further investigation. The management of ISR remains challenging even with the newest generation of drug-eluting stents. The use of intravascular imaging is highly recommended to identify the mechanisms of stent failure and to tailor the method of treatment, whether it is plain old balloon angioplasty, plaque/calcium modifying tools such as intravascular lithotripsy or rotational atherectomy, additional drug eluting stents, or drug coated balloons. Paclitaxel drug coated balloons are the most recent technological advancement which has provided an option to treat ISR that doesn't require further layers of metal. Currently, other drug coatings are being studied but it is unclear whether these balloons are as effective as paclitaxel coated balloons, with ongoing trials designed to answer this question.

PMID:40536538 | DOI:10.1007/s11886-025-02249-0

Indian J Thorac Cardiovasc Surg. 2025 Jul;41(7):955-957. doi: 10.1007/s12055-025-01973-0. Epub 2025 May 8.

ABSTRACT

In this review, we critically examine the 5-year outcomes of the Fractional Flow Reserve-Guided Percutaneous Coronary Intervention and Coronary Artery Bypass Graft Surgery in Patients With Multivessel Coronary Artery Disease (FAME 3) trial. While the composite outcome of death, stroke, or myocardial infarction showed no significant difference between the two strategies at 5 years, percutaneous coronary intervention was associated with higher rates of myocardial infarction and repeat revascularization. Coronary artery bypass graft surgery demonstrated greater benefit in patients with more complex coronary lesions. These findings stress the need for cautious interpretation of the trial findings and emphasize the value of long-term follow-up in assessing meaningful differences in clinical outcomes.

PMID:40535222 | PMC:PMC12170967 | DOI:10.1007/s12055-025-01973-0

IUBMB Life. 2025 Jun;77(6):e70035. doi: 10.1002/iub.70035.

ABSTRACT

Peroxisome proliferator-activated receptors (PPARs), particularly PPAR-α and PPAR-γ, are key regulators of cardiac energy metabolism and have been implicated in cardiac remodeling. However, their roles in cardiomyocyte proliferation and hypertrophy remain incompletely understood. In this study, we investigated the effects of PPAR-α and PPAR-γ modulation on neonatal rat cardiomyocytes (NRCMs) using pharmacological agonists (WY-14643 for PPAR-α and pioglitazone for PPAR-γ) and inhibitors (MK-886 for PPAR-α and GW9662 for PPAR-γ), as well as siRNA-mediated knockdown approaches. Cardiomyocyte proliferation and hypertrophy were assessed by immunofluorescence, cell size measurements, and proliferation assays. Our findings demonstrate that PPAR-α activation significantly promotes cardiomyocyte proliferation and reduces hypertrophy, whereas PPAR-α inhibition induces hypertrophic changes and suppresses proliferation. Similarly, PPAR-γ activation enhances both proliferation and hypertrophy of cardiomyocytes, suggesting its involvement in physiological hypertrophy and a potential protective role in pathological remodeling. In contrast, pharmacological activation or genetic inhibition of PPAR-δ showed no significant effects on cardiomyocyte proliferation or hypertrophy, highlighting its distinct role in metabolic homeostasis rather than structural remodeling. PPAR-α and PPAR-γ play distinct but complementary roles in regulating cardiomyocyte proliferation and hypertrophy. These results suggest that targeting PPAR-α and PPAR-γ may represent promising therapeutic strategies for cardiac hypertrophy and heart failure. Further in vivo studies are warranted to clarify their molecular mechanisms and potential clinical applications.

PMID:40536211 | DOI:10.1002/iub.70035

Open Life Sci. 2025 Jun 17;20(1):20221026. doi: 10.1515/biol-2022-1026. eCollection 2025.

ABSTRACT

Cardiovascular diseases (CVD) are the leading cause of death worldwide. Chemokines are a class of proteins that possess characteristics of both chemoattractants and cytokines. They play a pivotal role in CVD by regulating the recruitment of immune cells and suppressing inflammatory responses. These proteins are crucial for maintaining cardiac function and for managing myocardial cell damage under various stress conditions. Autophagy, a vital intracellular degradation mechanism, is essential for clearing misfolded proteins and damaged organelles, thus promoting cell survival during starvation and other stress conditions. A substantial body of research indicates that chemokines can modulate the development of CVD by influencing the autophagy process. Research has shown that targeting pathways such as CXCR4 and CXCL12, defective CXCL16/CXCR6, and inhibiting CX3CL1 can regulate autophagy and impact CVD. The protective role of chemokines in CVD through the modulation of autophagy may offer new perspectives for treatment.

PMID:40535169 | PMC:PMC12176010 | DOI:10.1515/biol-2022-1026

Front Cardiovasc Med. 2025 Jun 4;12:1511415. doi: 10.3389/fcvm.2025.1511415. eCollection 2025.

ABSTRACT

BACKGROUND: Hypertrophic Cardiomyopathy (HCM) is an inherited heart disease and the pathogenesis of HCM involves genetic mutations, hemodynamic stress, and metabolic factors, with myocardial fibrosis playing a crucial role in severe clinical events. IL-33/ST2 signaling pathway known for its roles in immune response and tissue repair, participates in cardiac protection and anti-cardiac fibrosis in heart failure. The role of ST2 in HCM remains unclear, and IL-33/ST2 pathway and broader inflammatory responses may be critical in HCM.

METHODS: We re-analyzed RNA sequencing data from 9 high-throughput sequencing datasets comprising myocardial tissue samples from 109 HCM patients and 210 non-HCM controls. Differential gene expression analysis, correlation analyses, and Gene Set Enrichment Analysis (GSEA) were employed to explore the biological significance of ST2-related genes and the IL-33/ST2 pathway. Immune infiltration was assessed using CIBERSORTx, and protein-protein interaction networks were constructed using the STRING database.

RESULTS: Our analysis identified 2,660 upregulated and 403 downregulated genes for HCM in the combined dataset, with significant downregulation of the ST2 gene (log2 fold change = -5.0, adjusted P-value = 9.2 × 10-¹⁴³). This downregulation was consistently observed across multiple individual studies. Correlation analysis revealed significant positive correlations between ST2 and key inflammatory mediators such as IL6 and CD163. GSEA highlighted the enrichment of pathways related to immune response, inflammation, and cardiac morphogenesis, with notable upregulation of pro-inflammatory pathways. Immune infiltration analysis revealed a significant inverse correlation between ST2 expression and regulatory T cells (r = -0.34) and a positive correlation with neutrophils (r = 0.39). Pathway analysis indicated ST2's key role in networks involving inflammatory and fibrotic responses.

CONCLUSIONS: Our findings suggest that downregulation of ST2 in HCM may be associated with a dysregulated inflammatory gene network, potentially contributing to myocardial fibrosis and remodeling. These results highlight the possible critical role of the IL-33/ST2 pathway in disease progression, offering a potential therapeutic target for managing inflammation and fibrosis in HCM.

PMID:40535153 | PMC:PMC12174446 | DOI:10.3389/fcvm.2025.1511415

J Orthop. 2025 May 29;68:191-196. doi: 10.1016/j.jor.2025.05.063. eCollection 2025 Oct.

ABSTRACT

STUDY DESIGN: Level of Evidence: Therapeutic Level III.

BACKGROUND AND OBJECTIVE: Aspirin is commonly used for VTE prophylaxis in orthopedic procedures due to its safety and cost-effectiveness. However, its association with thromboembolic outcomes in obese and morbidly obese patients undergoing LSS remains unclear, particularly in the absence of BMI-specific prophylaxis guidelines. This study evaluates whether venous thromboembolism (VTE) event rates differ by body mass index (BMI) category in patients undergoing lumbar spine surgery (LSS) treated with aspirin monotherapy.

METHODS: This retrospective cohort study leveraged the TriNetX database to identify adults undergoing LSS who received aspirin monotherapy. Patients were stratified by BMI into non-obese (<30 kg/m2) and obese (≥30 kg/m2) cohorts. After 1:1 propensity score matching, 23,139 patients were included in each group. A secondary analysis compared obese (BMI 30-39.9) and morbidly obese (≥40) subgroups. Outcomes included incidence of DVT and PE at 90 and 180 days, along with secondary complications such as hematoma and myocardial infarction.

RESULTS: Obese patients had higher observed rates of 90-day DVT (RR: 1.23, 95 % CI: 1.02-1.48) and PE (RR: 1.45, 95 % CI: 1.14-1.84) compared to non-obese patients. At 180 days, PE risk remained elevated (RR: 1.27, 95 % CI: 1.03-1.57), while DVT risk was no longer statistically significant. Morbidly obese patients had a higher 180-day PE risk than the obese group (RR: 1.54, 95 % CI: 1.03-2.29). No significant differences were observed in hematoma or myocardial infarction across groups.

CONCLUSION: Among patients undergoing LSS with aspirin monotherapy, PE risk remained elevated in obese and especially morbidly obese patients at 180 days, despite matched baseline characteristics. While differences were statistically significant, absolute risk increases were modest. These findings support the need for prospective studies to evaluate whether weight-adjusted dosing, alternative agents, or adjunctive mechanical prophylaxis may offer improved protection in high-BMI populations.

PMID:40534734 | PMC:PMC12171754 | DOI:10.1016/j.jor.2025.05.063

Front Physiol. 2025 Jun 4;16:1628944. doi: 10.3389/fphys.2025.1628944. eCollection 2025.

ABSTRACT

[This retracts the article DOI: 10.3389/fphys.2019.01445.].

PMID:40534640 | PMC:PMC12175564 | DOI:10.3389/fphys.2025.1628944

Circ Heart Fail. 2025 Jun 19:e012479. doi: 10.1161/CIRCHEARTFAILURE.124.012479. Online ahead of print.

ABSTRACT

BACKGROUND: Guided by long-term safety data for AAV5 (adeno-associated virus 5) in humans, our translational study investigated whether AAV5 effectively delivers genes to healthy and achieves therapeutic efficacy in dysfunctional human-sized hearts, using a clinically applicable mode of administration and vector dosages.

METHODS: AAV-mediated cardiac gene transfer in pigs was performed by percutaneous catheter-based retrograde intravenous vector delivery, and vector genome and transgene expression levels determined by RT-PCR and immunoblotting. Postmyocardial infarction (MI) cardiac dysfunction porcine and murine models were generated by coronary catheter-based occlusion and ligation, respectively. The study end points left ventricular ejection fraction and left ventricular MI size, were measured by cardiac magnetic resonance imaging and echocardiography. Bulk myocardial RNA-sequencing and weighted gene correlation network analysis were used to link study end points to molecular pathway mechanisms. Safety was assessed by clinical chemistry, blood count and ECG.

RESULTS: In a first biodistribution study, AAV5 (1×1013 vector genomes; vgs) with the reporter gene luciferase (luc) achieved broad and homogenous transduction of healthy pig hearts 30 days after catheter-based retrograde intravenous vector delivery without toxicity. Both its myocardial and extra-cardiac distribution patterns were advantageous compared with AAV9-luc and AAV6-luc. Using AAV5 with the cardioprotective human gene S100A1 (hS100A1; 1×1013 vgcs) by catheter-based retrograde intravenous vector delivery in a subsequent therapy study in post-MI pigs prevented left ventricular MI extension and improved left ventricular ejection fraction after 3 months without clinical toxicity. Weighted gene correlation network analysis linked novel antiinflammatory actions and cardioprotective signaling mechanisms by S100A1 to study end point improvements, which was confirmed in a post-MI mouse model.

CONCLUSIONS: Providing the clinically relevant proof of oncept for AAV5 to effectively transduce healthy and dysfunctional human-sized hearts, its clinical long-term safety, scalable producibility, and low preexisting immunity in humans may predestine AAV5 as an effective and safe gene carrier for a prevalent disease such as chronic heart failure, using therapeutic genetic effectors such as hS100A1 or others.

PMID:40534567 | DOI:10.1161/CIRCHEARTFAILURE.124.012479

Animal Model Exp Med. 2025 Jun 18. doi: 10.1002/ame2.70035. Online ahead of print.

ABSTRACT

BACKGROUND: There are many forms of anabolic steroids, including stanozolol (Winstrol), which are popular for their muscle-building effects but dangerous to the heart. This present work is aimed at evaluating the pharmacologica impact of allicin, a natural attribute obtained from garlic, on obstructing cardiac injury in rabbits that received stanozolol.

METHODS: Thirty rabbits were divided into three groups: control, stanozolol-treated, and stanozolol plus allicin. Cardiac function was assessed by measuring troponin, creatine kinase (CK), Galectin-3, and GDF-15. Oxidative stress and antioxidant markers, including malondialdehyde (MDA), glutathione, and catalase, were analyzed. Inflammatory mediators such as C-reactive protein (CRP), interleukin-6 (IL-6), NF-κB, iNOS, nitric oxide (NO), tumor necrosis factor-alpha (TNF-α), and interleukin-1 beta (IL-1β) were evaluated. Lipid profile parameters, including total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL), were measured. Histopathological examination assessed myocardial damage, fibrosis, and collagen deposition.

RESULTS: Stanozolol administration significantly increased cardiac damage markers, oxidative stress, and inflammatory mediators while causing dyslipidemia, characterized by elevated LDL and total cholesterol and reduced HDL. Allicin co-administration effectively countered these effects by reducing oxidative stress and inflammation, restoring antioxidant balance, and improving lipid profiles. Histopathological analysis revealed severe myocardial disorganization, necrosis, and fibrosis in the stanozolol group, whereas the allicin-treated group exhibited preserved myocardial structure with reduced collagen deposition.

CONCLUSION: Allicin significantly mitigates stanozolol-induced cardiotoxicity by reducing oxidative stress, inflammation, lipid dysregulation, and myocardial damage, as evidenced by biochemical and histopathological findings. These results suggest that allicin may serve as a potential therapeutic agent to counteract the cardiovascular risks associated with anabolic steroid use.

PMID:40534105 | DOI:10.1002/ame2.70035

Cardiooncology. 2025 Jun 19;11(1):55. doi: 10.1186/s40959-025-00354-1.

ABSTRACT

BACKGROUND: Childhood cancer survivors (CCS) often develop late complications after their primary disease is cured. Cardiovascular disease is one of the most frequent and serious complications that significantly affects prognosis and quality of life. Early detection and appropriate intervention are expected to improve their prognosis. However, the risk factors for late cardiotoxicity in CCS are not well defined, and biomarkers that can detect cardiac dysfunction prior to the development of heart failure have not yet been established.

METHODS: Medical records of childhood hematologic cancer survivors referred to our department for transitional care between January 2016 and October 2023 were reviewed for this cross-sectional study. The relationships between the most recent cardiac function at the review and history of cancer treatment were analyzed.

RESULTS: This study included 34 patients and the median elapsed time since cancer diagnosis was 16.5 years (range, 5-30 years). None of the patients had symptomatic cardiac complications. The E/e' ratio was significantly higher in survivors with a history of hematopoietic stem cell transplantation (HSCT) than in those who did not undergo HSCT (median, 8.4% vs. 6.25%, P = 0.040), while no intergroup differences were observed in ejection fraction (EF), global longitudinal strain (GLS), or the brain natriuretic protein (BNP) level. In addition, the E/e' ratio was positively correlated with years elapsed since cancer diagnosis (ρ = 0.38, P = 0.034). While there was no clear correlation between years since cancer diagnosis and the BNP level in the overall cohort, a strong correlation was found in patients with a history of HSCT (ρ = 0.73; P < 0.01). No significant differences were observed in EF, E/e' ratio, GLS, and BNP level by cumulative anthracycline dose or history of chest irradiation.

CONCLUSIONS: In this study, no patient had late symptomatic cardiac complications. However, in those who had survived for a long time since their cancer diagnosis, particularly those with a history of HSCT, there were significant elevations in the E/e' ratio and the BNP level. Continuous follow-up is required to determine whether these abnormalities lead to symptomatic cardiotoxicity and whether they serve as useful markers for the early detection of cardiac complications.

PMID:40537853 | PMC:PMC12177987 | DOI:10.1186/s40959-025-00354-1

Clin Lymphoma Myeloma Leuk. 2025 May 23:S2152-2650(25)00179-X. doi: 10.1016/j.clml.2025.05.014. Online ahead of print.

ABSTRACT

BACKGROUND: Amyloidosis is a condition characterized by deposition of insoluble protein fibrils in tissues, leading to diverse clinical manifestations. There is limited data addressing amyloidosis from India.

OBJECTIVE: This study aims to systematically review the available clinical data on amyloidosis in India. By synthesizing existing knowledge, the review seeks to identify research gaps that require further exploration.

METHODS: A systematic review was conducted using the PubMed database to identify English-language articles on amyloidosis from India published between 1959-2023. Additionally, abstracts from international conferences were analyzed. Data extracted were-type of amyloidosis, demographics, clinical presentation, diagnostic methods, and outcomes.

RESULTS: The median age at presentation in Indian patients was approximately 10 years younger (50 years) compared to their counterparts in Western countries (60 years), with males comprising 70% of the cases. Renal involvement was the most common, with AA being more prevalent than AL amyloidosis, often secondary to tuberculosis. Cardiac involvement was second most common, affecting 40%-50% of patients. In patients with paraproteinemic neuropathies, AL amyloidosis accounts for the cause in 4% cases. Treatment of AL amyloidosis primarily involved chemotherapy and supportive care, with autologous transplantation underutilized due to resource limitations. Amongst localized amyloidosis, skin was the most common site (68% of all cases).

CONCLUSION: Amyloidosis in India remains a significant and often underdiagnosed condition, with varied presentations and causes. Most data come from retrospective studies, highlighting variability in presentation and outcomes. This review underscores the importance of understanding the disease burden and advancing research to improve outcomes in India.

PMID:40537367 | DOI:10.1016/j.clml.2025.05.014

JACC CardioOncol. 2025 Jun;7(4):411-413. doi: 10.1016/j.jaccao.2025.04.002.

NO ABSTRACT

PMID:40537189 | DOI:10.1016/j.jaccao.2025.04.002

JACC CardioOncol. 2025 Jun;7(4):393-395. doi: 10.1016/j.jaccao.2025.05.008.

NO ABSTRACT

PMID:40537188 | DOI:10.1016/j.jaccao.2025.05.008