Current Issue : April-June Volume : 2026 Issue Number : 2 Articles : 5 Articles
Catheter ablation (CA) has become a validated technique for treating patients with symptomatic or paroxysmal atrial fibrillation (AF), as recommended by the latest 2024 European society of cardiology (ESC) guidelines, class II level A. The procedure is also recommended for patients with persistent AF without major risk factors for AF recurrence, as an alternative to antiarrhythmic medications class I or III. However, CA carries the risk of AF recurrence in 30–35% of patients, sometimes after the procedure. Multiple factors impact the onset, maintenance, and recurrence of AF after CA, including clinical, biohumoral, echocardiographic, genetic, and lifestyle factors. Beyond traditional predictors, emerging factors such as obstructive sleep apnea syndrome, chronic renal failure, chronic lung disease, physical activity patterns, gut microbiota composition, and epicardial fat thickness significantly influence outcomes. Therefore, optimizing patient’s selection for CA is an important strategy to minimize the risk of AF recurrence. Many echocardiographic parameters emerged as predictors of AF recurrence post-CA, but none stood out as a potential single factor. These factors include traditional markers such as left atrial size by 2D echocardiography, LV ejection fraction, LV diastolic function parameters as well as myocardial deformation addressed by the recently developed speckle tracking analysis. Additionally, the duration and type of AF represent fundamental risk factors, with longstanding persistent AF showing significantly higher recurrence rates compared to paroxysmal forms. Novel biomarkers including MR-proANP, caspase-8, hsa-miR-206, and neurotrophin-3 show promise in enhancing risk prediction capabilities. The aim of this review is to explore the most relevant echocardiographic parameters, including myocardial deformation, that could accurately predict recurrence of AF after CA, while also examining the role of emerging clinical and biochemical predictors in comprehensive patient selection strategies....
Background/Objectives: Teclistamab is a bispecific antibody targeting BCMA and CD3, approved for relapsed/refractory multiple myeloma. It is administered continuously until progression or intolerance; however, prolonged use may increase infections and treatment burden. This study compares continuous versus fixed-duration teclistamab to determine whether treatment discontinuation after response is feasible without compromising outcomes. Methods: A multicenter retrospective study was conducted on adults with relapsed/refractory multiple myeloma treated with teclistamab between August 2022 and May 2024. Patients received step-up dosing followed by weekly administration. Those who achieved ≥VGPR and discontinued therapy due to deep response, toxicity, or preference were assigned to the fixed-duration group. Outcomes included response rates, progression-free survival (PFS), overall survival (OS), and adverse events. Results: Eighty-eight patients were included (continuous: n = 72; fixed: n = 16). The fixed group had higher complete response rates (69% vs. 44%) and shorter median time to best response (1 vs. 2 months). Median PFS was 16 months for continuous dosing versus 13 months for fixed-duration. Twelve-month PFS was similar (65% vs. 66%). Twelve-month OS was 83% vs. 81% in the continuous and fixed groups, respectively. Cytokine release syndrome and neurotoxicity rates were similar. Infections were more frequent and severe in the fixed cohort (75% any grade; 69% grade ≥ 3). Conclusions: Fixed-duration teclistamab after deep response appears feasible in appropriately selected patients, with comparable early survival outcomes to continuous treatment. Prospective studies are needed to define selection criteria, immune recovery markers, and optimal discontinuation timing....
Introduction: Inadequate blood pressure (BP) control is a significant challenge. Therapeutic decisions based on home blood pressure monitoring (HBPM) have been shown to lead to better blood pressure control compared to those based on office blood pressure (OBP) measurements alone. Objectives: To compare, over a five-year period, the annual BP control rates in hypertensive patients who were treated and monitored by the same cardiologists and who periodically used HBPM. Methodology: This was a multicenter study conducted with five cross-sectional analyses at annual intervals, with the first in 2019 and the last in 2023. OBP and HBPM measurements were performed according to current guidelines. Two cutoff points were considered for the analysis of BP control by OBP: <140/90 mmHg and <130/80 mmHg. For HBPM, the cutoff was <130/80 mmHg. Comparisons of quantitative variables between years were established using the t-test or chi-square test. A p-value < 0.05 was considered significant. Results: A total of 8,890 individuals with a mean age of 63.3 (±14.9) years were included, of whom 65.8% were women. A reduction in mean OBP values was observed between 2019-2020 and 2021-2022. There was also a reduction in the average number of antihypertensive medications used in 2020, with a mean of 1.99 medications taken that year. Compared to 2020, 2022 showed an improvement in control rates for OBP < 130/80 mmHg (31.5% vs. 35.7%; p = 0.008) and OBP < 140/90 mmHg (58.7% vs. 65.7%; p < 0.001). Conclusion: Continuous monitoring by the same physician and the use of home measurement tools can lead to better BP control in hypertensive patients....
Purpose: This systematic review aimed to evaluate the effectiveness of virtual reality (VR) technology in cardiac rehabilitation (CR) patients, focusing on cardiopulmonary function, quality of life, adherence, and satisfaction. Methods: Conducted following PRISMA guidelines and registered on PROSPERO (CRD42025643632), this study systematically searched PubMed, Web of Science, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Scopus, CNKI, and Wanfang Data. Metaanalysis was performed using RevMan 5.4 to assess the impact of VR interventions on cardiopulmonary function, quality of life (QOL), adherence, and satisfaction compared to conventional CR programs. Results: Twenty studies were included. Meta-analysis revealed that VR improved the 6 min walk test distance (MD: 34.9, 95% CI: 24.43, 45.37; p < 0.00001, I2 = 67%) and QOL (SMD: 0.63, 95% CI: 0.09, 1.17; p = 0.002, I2 = 86%). However, evidence regarding adherence and satisfaction was inconclusive. Conclusions: VR technology outperforms traditional CR in enhancing cardiopulmonary function and quality of life. While it might improve patient adherence, further research is necessary to confirm these findings....
Background Ischaemic heart disease (IHD) is a leading cause of mortality and morbidity globally. Coronary angioplasty has a vital role in treating coronary artery disease. However, this is associated with a small risk of serious side effects, including contrast-induced nephropathy, vascular complications and arrhythmia. Contrast-induced nephropathy (CIN) is a serious and common complication of coronary angioplasty that can lead to renal failure and major adverse cardiac and renal outcomes. Methods We conducted a systematic review and meta-analysis by searching multiple databases, including PubMed, Scopus, Embase, Google Scholar, and ScienceDirect, as well as other sources. The inclusion and exclusion criteria are described in detail later in this article. Two independent reviewers performed the literature search in September 2024 and identified 282 articles. The study was conducted following the population, intervention, comparator, and outcome (PICO) framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 17 studies were included in the final analysis after applying the inclusion and exclusion criteria. The exclusion criteria were guidelines, case reports, qualitative research, and letters to the editor, commentaries, conference proceedings, gray literature, opinions, policy papers, and case series. Articles published after 2010 were included in this meta-analysis, and data analysis was performed using Rayyan statistical software. Results This study demonstrated that nicorandil was associated with protective effects against CIN. The total number of patients in the Nicorandil and placebo groups were 3836 and 3858 respectively. The occurrence of CIN was 5.14% in the nicorandil group, compared with 13.15% in the control group. This study also confirmed the dose-dependent effect of nicorandil on CIN. Among 662 patients enrolled in three studies, 3,9% in the double dose (DD) group presented with CIN, compared with 8,4% in the standard dose (SD) group. The occurrence of MACE was 5.7% in the Nicorandil group and 8.2% in the control group. However, there was no statistically significant protective effect against major adverse cardiovascular events (MACE) or major adverse kidney events (MAKE). Only a few studies measured the impact on MAKE, and the findings may not be truly representative of its effects. Conclusion This study demonstrated the renoprotective effects of nicorandil in preventing CIN in patients undergoing coronary angioplasty, and this relationship was also evident from the double-dose response. Further larger size randomised controlled trials are recommended to assess the efficacy of nicorandil in preventing CIN in patients undergoing coronary angioplasty....
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