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Cardiol Young. 2025 Jul;35(7):1472-1475. doi: 10.1017/S1047951125101406. Epub 2025 Aug 13.

ABSTRACT

We present an extremely rare case of anomalous single coronary artery from the pulmonary artery in a 2-month-old infant with severe heart failure. Due to the unique coronary anatomy, a modified venous arterial extracorporeal membrane oxygenation technique was employed to maintain coronary perfusion and prevent coronary steal. Following surgical reimplantation, the patient showed significant recovery and remains stable at 2-year follow-up.

PMID:40799112 | DOI:10.1017/S1047951125101406

Medicine (Baltimore). 2025 Aug 8;104(32):e43741. doi: 10.1097/MD.0000000000043741.

ABSTRACT

RATIONALE: Streptococcal toxic shock syndrome (STSS) is an invasive Streptococcus pyogenes infection characterized by hypotension and multiple organ failure with rapid progression and high mortality. Although extracorporeal membrane oxygenation (ECMO) has been used in adults with STSS, mortality remains high and optimal mechanical circulatory support is controversial. Veno-arterial ECMO has specific complications in severe cardiopulmonary failure, including differential hypoxia and increased left ventricular end-diastolic pressure due to retrograde flow.

PATIENT CONCERNS: A 51-year-old man presented to the emergency department with fever and dyspnea, progressing rapidly from an initially diagnosed upper respiratory tract infection to severe respiratory distress and refractory shock requiring oxygen supplementation and vasopressor support.

DIAGNOSES: The patient was diagnosed with STSS, which manifested as septic shock with severe cardiopulmonary compromise.

INTERVENTIONS: We implemented a combined approach using veno-arteriovenous ECMO (V-AV ECMO) and Impella CP® support (veno-arteriovenous extracorporeal membrane oxygenation and Impella [VAVEcpella]). This strategy provided oxygenated blood to the right heart while achieving left ventricular unloading. This was done in conjunction with appropriate antibiotic therapy and source control measures.

OUTCOMES: The novel VAVEcpella approach successfully supported the patient through severe cardiopulmonary failure secondary to STSS-induced septic shock. To our knowledge, this is the first reported case of VAVEcpella implementation specifically for the management of STSS.

LESSONS: The VAVEcpella approach (combined V-AV ECMO and Impella support) may represent a viable rescue strategy for patients with severe cardiopulmonary failure secondary to septic shock, such as STSS, where traditional support methods have shown limited success.

PMID:40797469 | PMC:PMC12338243 | DOI:10.1097/MD.0000000000043741

Eur J Cardiothorac Surg. 2025 Sep 2;67(9):ezaf263. doi: 10.1093/ejcts/ezaf263.

ABSTRACT

OBJECTIVES: The "German Registry for Acute Aortic Dissection Type A" (GERAADA) long-term follow-up firstly investigates the neurologic outcomes over a 16-year timeframe and secondly determines whether acute Stanford type A aortic dissection (ATAAD) patients are at risk for secondary neurologic complications.

METHODS: Thirty-three centres provided follow-up data of 2686 individuals. Of those, 814 provided long-term data regarding their neurological status and incidence of stroke. Multivariable regression analysis was used to identify risk factors of both postoperative and secondary neurologic deficits. Subgroup analyses of patients operated in hypothermic circulatory arrest with or without selective antegrade cerebral perfusion was performed to assess further influencing factors.

RESULTS: Four hundred and fifteen (15%) out of the 2686 patients experienced postoperatively a new-onset neurologic deficit while being hospitalized. Age, renal malperfusion, dissected supra-aortic vessels, extracorporeal circulation time, and re-exploration were independent risk factors (all P < .05) for worse neurological outcomes while hemiarch replacement seemed to have a protective effect (OR = 0.68; P = .008). Neither cerebral protection strategy nor temperature management showed significant differences between the groups regarding neurological outcome. Out of the 814 follow-up patients, 188 (23%) experienced secondary neurologic deficits after initial treatment for ATAAD within a median follow-up of 10.2 years. Long-term risk factors were a persistent cerebral malperfusion and late reoperation. No association between perioperative neurologic damage and operative techniques on long-term neurologic outcomes could be found.

CONCLUSIONS: Surgery for ATAAD is associated with frequent early neurologic complications that can be predicted by perioperative factors. Open treatment of the aortic arch shows a positive effect on neurological outcome. Further, every fourth follow-upped patients suffered from secondary neurological damage highlighting the importance of a close surveillance.

PMID:40796127 | DOI:10.1093/ejcts/ezaf263

Transl Stroke Res. 2025 Aug 12. doi: 10.1007/s12975-025-01376-8. Online ahead of print.

ABSTRACT

BACKGROUND: Prior clinical research demonstrated that rapid reduction in arterial carbon dioxide (PaCO2) levels during extracorporeal membrane oxygenation (ECMO) is associated with acute brain injury (ABI), which may be due to sudden cerebral vasoconstriction and impaired cerebrovascular autoregulation (CVAR). However, the causal relationship between rapid PaCO2 correction and its impact on ABI has not been firmly established due to the lack of high-quality evidence. We aimed to investigate whether rapid PaCO2 correction following extracorporeal cardiopulmonary resuscitation (ECPR) causes CVAR impairment and neuronal injury in a porcine model.

METHODS: In this prospective preclinical experimental study, six female pigs (mean weight: 50.75 ± 1.89 kg) were subjected to 15 min of ventricular fibrillation and were then supported by ECMO. The return of spontaneous circulation (ROSC) was attempted in animals at 20 min post-ECMO initiation. Arterial blood gas (ABG) was sampled at specific time points, while arterial blood pressure (ABP) and intracranial pressure (ICP) were continuously monitored. Sweep gas flow was set relative to each animal's ECMO flow rate: 100% in the control group, 200% in the rapid correction group, and 25% in the slow correction group. PRx was computed as the Pearson correlation coefficient between 10-s average mean arterial pressure (MAP) and ICP values using 1-min windows updated every 30 s. Experimental phases were defined for data analysis, including baseline, fibrillation, ECMO I (0-10 min after ECMO initiation), ECMO II (10-20 min), and POST-R (post-ROSC, 20-30 min). Linear mixed-effects models were used to assess group-wise differences in ΔPRx over time. Histopathological analysis was performed to quantify neuronal injury across cortical and subcortical regions. Brain tissues were harvested and histologically analyzed for neuronal injury ischemia vulnerable regions: the midbrain, cerebellum, striatum in the basal ganglia, temporal cortex, hypothalamus, and hippocampus.

RESULTS: In the rapid group, PaCO2 correction caused a steep drop in PaCO₂-from 60 to approximately 30 mmHg within 5 min-and was associated with impaired CVAR. Following ECMO initiation, the rapid group exhibited a significant rise in ΔPRx, indicating impaired CVAR. Group differences in ΔPRx were significant at ECMO I (F = 8.12, p = 0.001), ECMO II (F = 6.21, p = 0.003), and POST-R (F = 13.47, p < 0.001). At ECMO II, median PRx in the rapid group was 0.50 (IQR: 0.10, 0.78), significantly higher than the control (0.11, IQR: - 0.27, 0.42) and slow (0.38, IQR: - 0.06, 0.55). Histologically, the rapid correction group exhibited significantly increased ischemic neuronal injury in ischemia-prone regions: caudate (43.1% injured neurons vs. 10.6% in control, p = 0.041), putamen (66.6% vs. 23.9%, p = 0.003), temporal cortex (34.9% vs. 8.9%, p = 0.013), and hippocampal CA-3 region (4.7% vs. 18.0%, p = 0.026). Compared to rapid correction, the slow correction group demonstrated improved gas stability (PaCO2 decline of ~ 10 mmHg over 10 min), preserved PRx (mean PRx < 0.2), and significantly reduced neuronal injury in the putamen (p = 0.004).

CONCLUSION: In this experimental ECPR model, faster early PaCO2 correction was associated with impaired CVAR (higher PRx values). Controlled CO2 correction should be considered a key neuroprotective strategy during ECMO initiation.

PMID:40794248 | DOI:10.1007/s12975-025-01376-8

Medicina (B Aires). 2025;85(4):861-865.

ABSTRACT

We present the case of a 69-year-old male with no cardiovascular history, who was admitted to the emergency department due to acute coronary syndrome with ST elevation and cardiogenic shock. Immediately after the percutaneous coronary intervention, he developed a greater requirement of vasopressors, the addition of inotropes, and an increase in oxygen supply by mechanical respiratory assistance. An echocardiogram was performed, which showed acute ischemic mitral regurgitation due to complete rupture of the posteromedial papillary muscle. Under ventricular assistance with a counterpulsation balloon, a mitral valve replacement was decided, and he left the operating room with extracorporeal membrane for oxygenation (ECMO). During the postoperative period, the patient evolved adequately, achieving the retirement of the ECMO at 72 hours with good hemodynamic tolerance. Respiratory weaning was prolonged. Once pulmonary rehabilitation was completed, he was discharged from the hospital.

PMID:40793898

Anesthesiology. 2025 Sep 1;143(3):518-532. doi: 10.1097/ALN.0000000000005559. Epub 2025 Aug 12.

ABSTRACT

Cardiac output is a key cardiovascular variable quantifying global blood flow. The measurement performance of cardiac output monitoring methods is investigated in validation studies, which are method comparison studies determining the agreement between cardiac output values measured with a test method and those measured with a reference method. The StatistiCal analysis and repOrting of cardiac output Method comPARison studiEs (COMPARE) statement provides a framework for designing, performing, and reporting cardiac output method comparison studies and includes a checklist of 29 items that are essential for reporting of those studies. Considering and reporting the items specified in the COMPARE checklist will help standardize cardiac output method comparison studies and increase the external validity of the results.

PMID:40793805 | DOI:10.1097/ALN.0000000000005559

BMC Emerg Med. 2025 Aug 8;25(1):149. doi: 10.1186/s12873-025-01275-z.

ABSTRACT

BACKGROUND: Sudden cardiac arrest represents a global health challenge characterized by high mortality and morbidity rates. Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly considered as an effective treatment for cardiac arrest; however, its application remains a subject of debate. Furthermore, limited studies have analysed out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) populations within the same context.

METHODS: This study involved the selection of patients who experienced cardiac arrests and were supported by ECPR in 939 tertiary hospitals across 31 provinces between 2016 and 2021. The data was derived from the ECMO Quality Improvement Project.

RESULTS: Among the 939 tertiary hospitals, a total of 6374 patients who had cardiac arrest events were identified, categorized as OHCA (1465) and IHCA (4909). Survivors in the IHCA group were comparatively younger (50 [IQR: 33-62] vs. 53 [IQR: 38-64], p < 0.001) and more likely to be female (34.2% vs. 29.8%, p < 0.05), while in the OHCA group, survivor characteristics remained similar. Multivariable modelling indicated that in the IHCA group, age ≥ 60, regions with lower GDP, acute respiratory distress syndrome (ARDS), sepsis, electrolyte disturbance, hypertension, acute renal failure, and disseminated intravascular coagulation (DIC) were identified as independent risk factors associated with hospital mortality. Conversely, being female, experiencing arrhythmia, myocarditis, and acute heart failure were identified as protective factors. In the OHCA group, independent risk factors included regions with lower GDP, hypertension, and DIC, while arrhythmia, myocarditis, ARDS, and acute heart failure were protective factors.

CONCLUSIONS: This nationwide prospective observational study provides insights into the utilization of ECPR among patients experiencing OHCA and IHCA. It also underscores the disparity in risk factors and outcomes between OHCA and IHCA populations, indicating differences in clinical practices. Notably, DIC is recognized as a risk factor associated with mortality. Although the exact mechanism remains unclear, it is recommended as a screening indicator for risk stratification.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40781599 | PMC:PMC12335052 | DOI:10.1186/s12873-025-01275-z

Crit Care. 2025 Aug 7;29(1):349. doi: 10.1186/s13054-025-05569-3.

ABSTRACT

BACKGROUND: Thrombocytopenia is a recognized risk factor for bleeding during extracorporeal membrane oxygenation (ECMO). This study determines the incidence, risk factors, and clinical relevance of thrombocytopenia and platelet transfusions during venovenous (VV) ECMO.

METHODS: The multicenter, prospective observational PROTECMO study included 652 adult patients who received VV ECMO for respiratory failure. Thrombocytopenia was classified as mild (100-149·109/L), moderate (50-99·109/L), or severe (< 50·109/L). Bleeding events were evaluated using a modified Bleeding Academy Research Consortium score. Cox proportional hazards and logistic regression analyses were done to identify predictors, and quantify the association between platelet counts and bleeding risk.

RESULTS: A total of 182 patients (27.9%) had thrombocytopenia at baseline (mild in 14.7%, moderate in 8.7%, and severe in 4.4%). Thrombocytopenia during ECMO, at least once in 80.2% of patients, was mild in 21.3% of cases, moderate in 32.2%, and severe in 26.7%. A 10·109/L decrease in platelet count was associated with a 3.7% (95% CI: 2.4-5.0%) increase in risk of bleeding. There was no strong evidence of nonlinear relationship within the platelet count range between 25,000 and 300,000. This relation remained consistent across all ECMO weeks. Mild thrombocytopenia increased the risk of experiencing a bleeding event by 61% (hazard ratio (HR) 1.611, 95% CI 1.230-2.109, p = 0.0005), while moderate and severe thrombocytopenia increased the risk by roughly 90% (moderate: HR 1.944 (CI 1.484-2.545), p < 0.0001; severe: HR 1.876 (CI 1.275-2.7680), p = 0.0014). The risk for thrombocytopenia < 100·109/L during ECMO significantly increased with ICU days prior to ECMO start, postoperative admission, immunocompromised state, renal replacement therapy, septic shock, low hemoglobin, and circuit exchange.

CONCLUSIONS: Thrombocytopenia is highly prevalent in VV ECMO, and associated with a significant increase in the risk of bleeding, and a reduction in 6-month survival, particularly at platelet counts below 100·109/L. Further research is needed to better define the outcomes associated with specific thresholds for transfusion of platelets.

PMID:40775790 | PMC:PMC12329957 | DOI:10.1186/s13054-025-05569-3

Resusc Plus. 2025 Jun 24;25:101017. doi: 10.1016/j.resplu.2025.101017. eCollection 2025 Sep.

ABSTRACT

BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is a major public health problem. This study aims to describe the international variations in the practices related to the initiation, termination, and refraining from resuscitation of adult patients (≥18 years) with a non-traumatic OHCA.

METHODS: An exploratory descriptive study was conducted using a cross-sectional online survey. The respondents were recruited using snowball sampling technique. Framework analysis was used to identify key themes in responses, with descriptive statistics summarising data trends.

RESULTS: The study collected responses from 59 countries. Our findings reveal that respondents from 59.3% of countries reported that they initiate resuscitation in all cases where the patients do not show obvious signs of irreversible death or do not have confirmed advance directives. Respondents from 15.3% of countries reported that once started, prehospital resuscitation attempts are not terminated. Prehospitally respondents from 20.3% of the countries reported that they rely exclusively on specific criteria to decide when to terminate resuscitation efforts while in 45.8%, these decisions are made at the discretion of the provider. Respondents from most countries (91.5%) reported that they refrain from resuscitation in the presence of obvious signs of irreversible death. Respondents from 57.6% of countries, reported that they refrained from resuscitation if the patient had a confirmed do-not-attempt-cardiopulmonaryresuscitation (DNACPR), while 15.3% mentioned staff safety as a reason to abstain from attempting resuscitation.

CONCLUSION: This study reveals global variation in EMS resuscitation practices, reflecting disparities in resources, healthcare infrastructure, EMS system design, community acceptability given cultural and societal norms, and legislation.

PMID:40777886 | PMC:PMC12329125 | DOI:10.1016/j.resplu.2025.101017

Tissue Eng Part B Rev. 2025 Aug 7. doi: 10.1177/19373341251364282. Online ahead of print.

ABSTRACT

Myocardial infarction (MI), a prevalent critical cardiovascular disease (CVD), poses a severe threat to patients' lives. Despite the availability of pharmacological, interventional, and surgical treatments in clinical practice, these conventional therapies encounter the bottleneck of difficulty in repairing and reconstructing damaged myocardial tissue. Additionally, novel cardiac repair approaches based on stem cell and cardiomyocyte injections are restricted by the harsh microenvironment of infarcted areas. However, biomaterial hydrogels emerge as promising candidates for MI treatment due to their strong mechanical properties, good biocompatibility, high water absorption capacity, and excellent anti-inflammatory and antioxidant properties. These features enable them to enhance the microenvironment, promote myocardial regeneration, and restore myocardial function. This article delves into the therapeutic effects of sodium alginate (SA) and its composite hydrogel materials in repairing and regenerating myocardial injuries caused by MI. Furthermore, it offers insights into the future research directions of SA and its composite hydrogel materials. It also explores their potential applications in the field of CVDs. Impact Statement This review article highlights the significance and potential impact of sodium alginate (SA)-based hydrogels in myocardial infarction (MI) treatment. It effectively communicates the importance of the research, the gap in the current treatments for MI, and how the reviewed SA hydrogels offer a promising solution with their unique properties. It also clearly states the intended contribution to the field and the potential benefits for researchers and clinicians.

PMID:40772844 | DOI:10.1177/19373341251364282

J Anesth Analg Crit Care. 2025 Aug 6;5(1):50. doi: 10.1186/s44158-025-00271-w.

ABSTRACT

BACKGROUND: Perineural dexamethasone is widely used as an adjuvant to local anesthetics in regional anesthesia to prolong analgesia. However, concerns persist regarding its potential neurotoxic effects, particularly when administered perineurally. This systematic review aims to synthesize preclinical evidence evaluating the neurotoxicity or neuroprotective properties of perineural dexamethasone.

METHODS: A systematic search of PubMed, CENTRAL, Scopus, and Embase was conducted through May 22, 2025. Eligible studies included in vivo or in vitro preclinical models assessing the neurotoxic or neuroprotective effects of perineural dexamethasone compared to control conditions. Risk of bias was assessed using the SYRCLE tool for in vivo studies and a narrative evaluation for in vitro studies. A total of 14 studies (11 in vivo, 3 in vitro) met inclusion criteria.

RESULTS: In vitro studies showed that dexamethasone alone was not neurotoxic at clinically relevant doses but could enhance cytotoxicity when combined with local anesthetics at higher concentrations. In vivo models generally demonstrated no significant long-term nerve inflammation, degeneration or demyelination, with some early protective effects observed in perineural dexamethasone groups. However, all in vivo studies were rated at high risk of bias. In nerve injury models, dexamethasone reduced apoptotic and inflammatory markers when administered immediately post-injury, with limited effect when delayed.

CONCLUSIONS: Preclinical evidence supports the general safety of low-dose, preservative-free perineural dexamethasone. Nonetheless, high-dose use, additives, and application in patients with neuropathies may pose risks. Given the high risk of bias in existing studies and minimal added benefit over systemic administration, clinical caution is advised.

PMID:40770367 | PMC:PMC12329900 | DOI:10.1186/s44158-025-00271-w

Intensive Care Med. 2025 Sep;51(9):1674-1686. doi: 10.1007/s00134-025-08070-1. Epub 2025 Aug 6.

ABSTRACT

Extracorporeal Life Support (ECLS), including venovenous (VV) extracorporeal membrane oxygenation (ECMO) and extracorporeal carbon dioxide removal (ECCO2R) is a temporary support option for patients with severe respiratory failure. Current data and recent guidelines support the use of VV ECMO for select patients with very severe respiratory failure as this technique might improve survival in appropriately selected patients. Patient selection criteria, timing of ECMO initiation and optimal management of mechanical ventilation and anticoagulation, and other adjunctive treatment options are a matter of ongoing research.

PMID:40768066 | DOI:10.1007/s00134-025-08070-1

Circ Res. 2025 Aug 29;137(6):846-859. doi: 10.1161/CIRCRESAHA.125.326716. Epub 2025 Aug 5.

ABSTRACT

BACKGROUND: Myocardial ischemia-reperfusion (I/R) injury induces myocardial fibrosis that compromises cardiac function and electrical conduction, yet current clinical options remain inadequate. To address this unmet need, we explored macrophage-targeted lipid nanoparticles (LNPs) encapsulating FAP CAR (FAP [fibroblast activation protein]-targeted chimeric antigen receptor) mRNA for in vivo generation of FAP CAR macrophages and evaluated their therapeutic potential in reducing myocardial fibrosis and improving cardiac function after myocardial I/R injury.

METHODS: We formulated 1,2-dioleoyl-sn-glycero-3-phospho-l-serine-doping ALC-0315 (an ionizable lipid) LNP to deliver FAP CAR mRNA to generate FAP CAR macrophages. The platform was first validated in vitro by assessing phagocytosis of FAP-overexpressing fibroblasts by these macrophages. For in vivo evaluation, C57BL/6J mice subjected to I/R injury received intravenous administration of PBS, control LNPs, or LNP-FAP CAR (LNPs encapsulating mRNA encoding a FAP-targeting CAR). Comprehensive analyses included tracking the biodistribution of the resultant FAP CAR macrophages, quantitative measurement of fibrosis reduction, assessment of cardiac function by echocardiography, and safety evaluations.

RESULTS: LNP-FAP CAR successfully generated functional FAP CAR macrophages that demonstrated phagocytosis ability toward FAP-positive fibroblasts in vitro. In vivo studies revealed that intravenous delivery of LNP-FAP CAR generated functional FAP CAR macrophages that selectively engaged and phagocytosed activated cardiac fibroblasts in I/R mouse hearts. This targeted cell clearance translated to a significant reduction in the number of activated cardiac fibroblasts and the extent of myocardial fibrosis, as well as marked improvement in cardiac function without detectable toxicities. Notably, these effects were achievable even when intervention was delayed for up to 2 weeks post-I/R.

CONCLUSIONS: Our study demonstrates that FAP CAR macrophages generated in vivo by LNP-FAP CAR treatment effectively mitigate cardiac fibrosis and improve heart function after I/R injury, with lasting benefits and no observed toxicity. This safe and adaptable platform offers a promising treatment strategy for myocardial I/R injury and holds potential for treating other fibrotic heart diseases.

PMID:40762067 | DOI:10.1161/CIRCRESAHA.125.326716

Curr Cardiol Rev. 2025 Aug 1. doi: 10.2174/011573403X376065250728094646. Online ahead of print.

ABSTRACT

Cardiovascular diseases, especially myocardial infarction, remain the prominent causes of death globally, necessitating the exploration of innovative therapeutic strategies. Medical and surgical available treatments mainly manage disease symptoms and prevent deterioration, but do not focus on the repair of lost cardiomyocytes. Mesenchymal stem cells (MSCs) have emerged as a promising tool for heart repair and regeneration after injury, as they possess unique properties, such as the potential for differentiation into cardiomyocytes and vascular endothelial cells, immunomodulation, the release of mediators, and paracrine effects. This review focuses on the latest understanding of MSC therapies for cardiac repair, specifically addressing their properties, mechanism of action, preclinical and clinical studies, problems and prospects, and future strategies. MSCs can be isolated from various tissues, including bone marrow and adipose tissue, each with its own advantages and disadvantages in cardiac repair. Many preclinical studies conducted concluded that MSCs could differentiate into cardiomyocytes. MSCs involve multiple factors that enhance angiogenesis, promote the survival of existing myocardium and cardiomyocytes, reduce fibrosis, modulate the immune response, activate existing cardiac stem cells, and facilitate tissue remodeling; all of these processes are crucial in myocardial repair after MI. Although preclinical studies have promising outcomes, the application of MSC therapy in clinical trials has faced many challenges. Clinical trials conducted so far have yielded variable outcomes, with some showing marked improvements and others producing no promising results, indicating less improvement in cardiac function and mortality. This variability may be due to multiple sources, including MSCs, delivery methods, culture conditions, the timing of administration after MI, and patient-dependent factors, such as disease severity, overall patient well-being, and other comorbid conditions. The review concluded that although MSCs have a significant role in cardiac repair, further research is essential for overcoming current challenges to unlocking the maximum regenerative potential of these cells.

PMID:40760749 | DOI:10.2174/011573403X376065250728094646

J Stem Cells Regen Med. 2025 Jan 28;21(1):3-10. doi: 10.46582/jsrm.2101002. eCollection 2025.

ABSTRACT

The proposed topic is important because it helps find a lot of problems that happen when cardiovascular diseases are passed on along with fibrosis and the link between stem cells and myocardial regeneration. This study aims to investigate the effectiveness of autologous stem cells in the treatment of post-infarction myocardial changes. Statistical, bibliographic, and bibliosemantic research methods and scientific literature for the last 6 years were used to achieve the purpose. Cardiovascular diseases hold the highest prevalence and mortality rates, second only to the number of accidents. Today, there are many methods in the fight against coronary heart disease. However, drug therapy is the least effective, and instrumental methods are too invasive and entail several complications and side effects. Therefore, conducting detailed research on the impact of stem cells on the myocardium affected by infarction presents a challenge. Stem cell transplantation, which includes autologous bone marrow stem cells, typically leads to noticeable and significant changes in cardiac hemodynamic parameters and rheological properties. The development of autologous bone marrow stem cells during the angiogenesis process substantiates such metamorphoses. In addition, factors such as vascular endothelial growth factor and the whole list of coagulogram indicators may influence these changes. The practical significance of the raised subject is using stem cell therapy as an alternative, less invasive method in the fight against postinfarction myocardial changes.

PMID:40756129 | PMC:PMC12311326 | DOI:10.46582/jsrm.2101002

J Stem Cells Regen Med. 2025 May 29;21(1):1-2. doi: 10.46582/jsrm.2101001. eCollection 2025.

NO ABSTRACT

PMID:40756126 | PMC:PMC12311325 | DOI:10.46582/jsrm.2101001

Front Med (Lausanne). 2025 Jul 18;12:1649654. doi: 10.3389/fmed.2025.1649654. eCollection 2025.

NO ABSTRACT

PMID:40757198 | PMC:PMC12313688 | DOI:10.3389/fmed.2025.1649654

Br J Anaesth. 2025 Oct;135(4):1119-1121. doi: 10.1016/j.bja.2025.06.035. Epub 2025 Aug 5.

NO ABSTRACT

PMID:40753004 | DOI:10.1016/j.bja.2025.06.035

Front Cell Dev Biol. 2025 Jul 17;13:1612589. doi: 10.3389/fcell.2025.1612589. eCollection 2025.

ABSTRACT

Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) are revolutionizing the field of regenerative medicine, becoming the core carriers of next-generation acellular therapeutic strategies. In contrast to traditional mesenchymal stem cell therapy, these nanoscale "regenerative tiny giants" offer significant advantages, including low immunogenicity, efficient biological barrier penetration, and stable storage. As natural bioactive molecular carriers, MSC-EVs precisely regulate the inflammatory response, angiogenesis, and tissue repair processes in target tissues by delivering functional RNA, proteins, and other signaling elements. They have demonstrated multidimensional therapeutic potential in diseases such as bone and joint regeneration, nerve function reconstruction, myocardial repair, and skin wound healing. Worldwide, 64 registered clinical trials have preliminarily validated the safety and applicability of MSC-EVs across various diseases. Notably, they have shown significant progress in treating severe coronavirus disease 2019 (COVID-19), ischemic stroke, and complex wound healing. However, the lack of standardization in production processes, insufficient targeting for in vivo delivery, and the scarcity of long-term biodistribution data remain core bottlenecks limiting the clinical translation of MSC-EVs. Future interdisciplinary technologies, including 3-dimensional (3D) dynamic culture, genetic engineering, and intelligent slow-release systems, are expected to facilitate the transition of MSC-EVs from the lab to large-scale applications. This shift may transform "injectable regenerative factors" into "programmable nanomedicines", offering new solutions for precision medicine.

PMID:40746857 | PMC:PMC12310703 | DOI:10.3389/fcell.2025.1612589

J Cardiothorac Vasc Anesth. 2025 Oct;39(10):2677-2684. doi: 10.1053/j.jvca.2025.07.008. Epub 2025 Jul 11.

ABSTRACT

OBJECTIVES: To compare the efficacy of single-level and two-level deep parasternal intercostal plane (DPIP) blocks in managing postoperative pain in cardiac surgery patients undergoing median sternotomy.

DESIGN: A prospective, randomized controlled study.

SETTING: A cardiac surgery unit in a tertiary hospital, conducted under institutional ethical approval.

PARTICIPANTS: Adult patients (≥18 years) undergoing elective coronary artery bypass grafting (CABG), valve surgery, or combined CABG + valve procedures. Exclusion criteria included allergies to local anesthetics, emergency surgeries, reoperations, chronic pain, and major comorbidities.

INTERVENTIONS: Single-level DPIP block: 10 mL of 0.25% bupivacaine bilaterally at the T4/5 intercostal space. Two-level DPIP block: 5 mL bilaterally at T2/3 and T5/6 intercostal spaces. All blocks were administered preoperatively under ultrasound guidance.

MEASUREMENTS AND MAIN RESULTS: Both techniques provided effective analgesia. However, single-level blocks yielded significantly lower pain scores at 4, 6, and 8 hours, particularly during movement and in patients undergoing CABG. Differences decreased at 12 hours and disappeared by 24 hours. Pain scores were inversely correlated with age. No block-related complications were observed.

CONCLUSIONS: Single-level DPIP blocks demonstrated more consistent early analgesia and were technically simpler to perform. Given their efficacy, safety, and efficiency, single-level blocks may serve as a practical alternative for routine use in cardiac surgery. Further research is warranted to optimize block level, volume, and concentration based on patient and surgical characteristics.

PMID:40750549 | DOI:10.1053/j.jvca.2025.07.008