Heart Disease Research Articles

Cardiovascular Health Score and Atherosclerotic Cardiovascular Disease in the Million Veteran Program

The American Heart Association proposed Life's Essential 8 (LE8) as an enhanced measurement tool for cardiovascular health. To examine the association of LE8 with risk of atherosclerotic cardiovascular disease (ASCVD) incidence and prognosis in veterans. This was a prospective cohort study of US veterans enrolled in the Department of Veterans Affairs (VA) Million Veteran Program (MVP) between 2011 and 2022. Data were analyzed from 2023 to 2024. LE8 score ranged from 0 to 100, with higher score indicating better cardiovascular health. The primary outcome was total ASCVD incidence in veterans without baseline ASCVD, and the secondary outcome was incidence of a major adverse cardiovascular event (MACE) among veterans with and without ASCVD at baseline. A total of 413 052 veterans (mean [SD] age, 65.8 [12.1] years; 378 162 [91.6%] male) were included. Based on 1.7 million person-years of follow-up of 279 868 veterans without any ASCVD at baseline, 45 067 veterans had an ASCVD event during follow-up. Total LE8 score and each component LE8 factor score was associated with incident ASCVD in an inverse, linear, dose-response manner. For veterans without prior ASCVD, those with an LE8 score between 80 and 100 had lower risk of ASCVD compared with those with an LE8 score of 0 to 49 (adjusted hazard ratio [aHR], 0.36 [95% CI, 0.35-0.38]). Similarly, risk of MACE was significantly lower among veterans with an LE8 score of 80 to 100 regardless of baseline ASCVD status (with ASCVD: aHR, 0.52 [95% CI, 0.48-0.56]; without ASCVD: aHR, 0.14 [95% CI, 0.13-0.15]) compared with those with ASCVD and an LE8 score of 0 to 49. In this cohort study of US veterans, higher LE8 scores were associated with significantly lower ASCVD incidence risk and lower likelihood of developing adverse cardiovascular events regardless of ASCVD status at baseline. These results support the utility of LE8 for health promotion and ASCVD prevention.

Research Progress on the Intervention Effects of Different Exercise Forms on Risk Factors for Obesity-Related Cardiovascular Diseases

Obesity has become a major global health issue and is an independent risk factor for several cardiovascular risks. Exercise, as a therapeutic method, is commonly used to improve cardiovascular health in obese populations. This paper reviews and analyzes the effects of five different exercise forms on risk factors for obesity-related cardiovascular diseases: Moderate-Intensity Continuous Training (MICT), High-Intensity Interval Training (HIIT), Sprint Interval Training (SIT), aerobic combined with resistance training, and Blood Flow Restriction Training (BFR). The aim is to explore the similarities and differences in health benefits among these exercise forms for individuals with obesity. The review finds that MICT is notably effective in reducing cardiovascular disease risk factors and promoting cardiovascular health in obese individuals. In contrast, high-intensity interval exercises such as HIIT and SIT show even more significant improvements in cardiovascular health. This difference may be attributed to varying biological effects caused by different intensity levels and intervals, though the specific mechanisms require further clarification. Since increased skeletal muscle can enhance basal metabolic rate and positively impact the cardiovascular system, resistance training is often recommended in combination with aerobic training for better results. Additionally, BFR can achieve similar training effects under lower exercise loads, providing a safer training option for obese individuals. Future research should focus on the mechanisms by which different exercise forms affect specific cardiovascular disease risk factors and how to optimize exercise programs based on individual differences to enhance personalization and scientific validity of interventions.

A pilot study of the WE BEAT Well-Being Education Programme to build resilience in adolescents with heart disease.

To examine feasibility, acceptability, and preliminary effectiveness of a novel group-based telemedicine psychoeducation programme aimed at supporting psychological well-being among adolescents with Fontan-palliated CHD. A 5-week telemedicine psychoeducation group-based programme (WE BEAT) was developed for adolescents (N = 20; 13-18 years) with Fontan-palliated CHD aimed at improving resiliency and psychological well-being. Outcome measures included surveys of resilience (Connor-Davidson Resilience Scale), benefit finding (Benefit/Burden Scale for Children), depression, anxiety, peer relationships, and life satisfaction (National Institutes of Health Patient-Reported Outcomes Measurement Information System scales). Within-subject changes in these outcomes were compared pre- to post-intervention using Cohen's d effect size. In addition, acceptability in the form of satisfaction measures and qualitative feedback was assessed. Among eligible patients reached, 68% expressed interest in study participation. Of those consented, 77% have been scheduled for a group programme to date with 87% programme completion. Twenty adolescents (mean age 16.1 ± SD 1.6 years) participated across five WE BEAT group cohorts (range: 3-6 participants per group). The majority (80%) attended 4-5 sessions in the 5-session programme, and the median programme rating was a 9 out of 10 (10 = most favourable rating). Following WE BEAT participation, resiliency (d = 0.44) and perceptions of purpose in life increased (d = 0.26), while depressive symptoms reduced (d = 0.36). No other changes in assessed outcome measures were noted. These findings provide preliminary support that a group-based, telemedicine delivered psychoeducation programme to support psychological well-being among adolescents with CHD is feasible, acceptable, and effective. Future directions include examining intervention effects across diverse centres, populations, and implementation methods.

The POINTER Imaging baseline cohort: Associations between multimodal neuroimaging biomarkers, cardiovascular health, and cognition.

The U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER) is evaluating lifestyle interventions in older adults at risk for cognitive decline and dementia. Here we characterize the baseline data set of the POINTER Imaging ancillary study. Participants underwent health and cognitive assessments and neuroimaging with multimodal positron emission tomography (PET) (beta-amyloid [Aβ] and tau) and magnetic resonance imaging (MRI). Framingham risk score (FRS) was used to quantify cardiovascular disease (CVD) risk. A total of 1052 participants (31% from underrepresented ethnoracial groups) were enrolled. Compared to Aβ-, Aβ+ (29%) participants were older, had higher apolipoprotein E (APOE) ε4 carriage rate and white matter hyperintensity volume, and greater temporal tau. FRS was related to MRI measures, but not AD biomarkers. FRS and tau had independent effects on cognition. In this heterogenous, at-risk cohort, CVD risk was related to more abnormal brain structure and poorer cognition, representing a putative non-AD (Alzheimer's disease) pathway to brain injury and cognitive decline. ·The U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER) cohort is enriched for cardiovascular disease (CVD) and poor lifestyle ·POINTER Imaging collected multimodal neuroimaging data in this unique, at-risk cohort ·Amyloid burden was related to age, apolipoprotein E (APOE) ε4 carriage, and measures of disease progression ·Associations between amyloid and tau, and tau and cognition, were relatively weak ·CVD risk and tau pathology were independently related to memory.

The Invisible Dangers of Electronic Cigarettes and their Cardiovascular Effects

Objective: To investigate the relationship between electronic cigarettes (ECs) and cardiovascular diseases (CVDs), such as acute myocardial infarction (AMI). Theoretical Framework: Cardiovascular diseases are one of the main preventable causes of death globally, requiring sustainable policies to combat diseases such as AMI. The popularization of ECs increases concerns due to their illicit commercialization and lack of regulation. Method: Literature review using PRISMA, selecting 24 articles that met the inclusion criteria. Results and Discussion: Studies have not shown a clear association between daily use of ECs and cardiovascular events such as AMI. Smoking and hypertension were strongly associated with CVD. EC smokers had a lower risk of AMI than tobacco smokers, but a higher risk compared to non-smokers or ex-smokers. The dichotomy in the studies indicates the need for caution when considering ECs as a safe alternative to smoking. Research Implications: The lack of a clear association between the use of ECs and cardiovascular events highlights the need for further studies and careful interpretation of results. Considering the temporality of events is crucial to assess health risks. Originality/Value: This study highlights the importance of considering the chronology of events when evaluating associations between the use of ECs and health risks. It points to the need for future studies to better understand the impacts of ECs on cardiovascular health.

The evolution and hotspots of radioactive iodine therapy in hyperthyroidism: a bibliometric analysis.

Hyperthyroidism, a prevalent endocrine disorder, disrupts metabolic balance and cardiovascular health, affecting millions globally. Radioactive iodine (RAI), a treatment for hyperthyroidism, employs high-energy beta particles to reduce thyroid tissue, lowering volume and hormone levels. This study utilizes bibliometric analysis to outline RAI's evolution and identify hotspots in hyperthyroidism treatment. A total of 2904 articles and reviews published between 1981 and 2023 were retrieved from the Web of Science Core Collection using the research strategy. Bibliometric analyses, employing VOSviewer and CiteSpace, were performed to visualize the cooperation network, evolution, and hot topics. Annual publications rose in waves, 2904 papers from 2564 institutions, and 84 countries. The USA led, contributing the largest share, with the journal Thyroid dominating publication. The University of Pisa contributed the most articles. Co-occurrence analysis classified keywords into five clusters: treatment mechanism, safety, effectiveness assessment, individualized radioactive dosage, and management. The development of RAI therapy for hyperthyroidism can be divided into three stages: safety and efficacy assessment, personalized treatment plans, and treatment of drug-resistant and surgery-resistant hyperthyroidism. Attention to RAI in hyperthyroidism should be significantly increased. It is necessary to establish collaborations between authors, countries, and institutions to promote the development of this field. Recent research has focused on personalized radioactive dosage formulation and follow-up. Future studies are likely to concentrate on drug-resistant and surgery-resistant hyperthyroidism, which is also worthy of investigation. These findings provide a new perspective on the study of RAI in hyperthyroidism, potentially contributing to the improvement of the quality of life for patients with hyperthyroidism.

A depressed patient in outpatient settings

Depression is a clinically significant and growing public health issue. As a major global disease burden, its prevalence has been steadily increasing over the years, affecting different demographic groups. Depressive disorder is characterized by a low mood, loss of strength, sadness, insomnia, and inability to feel pleasure. In outpatient settings, up to one-third of patients with depressive symptoms may have a comorbidity. Many different diseases have been associated with depressive symptoms. Cardiovascular, metabolic, inflammatory, oncological, and neurological disorders are associated with an increased risk of depression, potentially due to chronic inflammation, neurochemical dysregulation, and emotional and social issues. As different drugs can cause depressive symptoms, the patient's medical history should include an assessment of the use of such drugs. Primary care physicians play an important role in identifying and treating depression. It is recommended to perform depression screening in all adult female patients in primary care facilities. There are general recommendations for the initial treatment of mild to moderate depressive disorder in adults. In mild depression, initial preference should be given to psychotherapy and symptom monitoring, and if improvement is insufficient, pharmacotherapy is to be used. Psychotherapy, pharmacotherapy or a combination of both should be considered for patients with moderate depression. Psychiatric consultation is recommended for patients with severe depression and urgently for any patient with psychotic symptoms or suicidal thoughts and behaviour. Antidepressants are the basic therapy for depression. Selective serotonin reuptake inhibitors are considered the first-line drugs to treat depression.

Imperfect wound healing sets the stage for chronic diseases.

Although the age of the genome gave us much insight about how our organs fail with disease, it also suggested that diseases do not arise from mutations alone; rather, they develop as we age. In this Review, we examine how wound healing might act to ignite disease. Wound healing works well when we are younger, repairing damage from accidents, environmental assaults, and battles with pathogens. Yet, with age and accumulation of mutations and tissue damage, the repair process can devolve, leading to inflammation, fibrosis, and neoplastic signaling. We discuss healthy wound responses and how our bodies might misappropriate these pathways in disease. Although we focus predominantly on epithelial-based (lung and skin) diseases, similar pathways might operate in cardiac, muscle, and neuronal diseases.

Cytotoxic effects of the standardized extract from Curcuma aromatica Salisb. rhizomes via induction of mitochondria-mediated caspase-dependent apoptotic pathway and p21-mediated G0/G1 cell cycle arrest on human gastric cancer AGS cells

ABSTRACT Curcuma aromatica Salisb. (C. aromatica) is one of the traditional herbs used to treat microbial infection, skin eruption, coronary heart disease, and other diseases, including cancer. However, the inhibitory effects and underlying mechanisms of action of C. aromatica on gastric cancer cells have not yet been fully elucidated. Our study aimed to examine the possible molecular mechanisms underlying the cytotoxic effects attributed to C. aromatica rhizome standardized extract against gastric cancer cells. The components of two major active compounds in C. aromatica rhizome extract were quantitatively analyzed using a simple and validated HPLC method. Cytotoxicity was determined in different gastric cancer and non-cancer cell lines. The biological activities of the extract targeting apoptosis and cell cycle-related genes on gastric cancer AGS cells were also investigated to elucidate the mechanisms relating to the anti-proliferative effect of C. aromatica rhizomes. The two major active compounds curdione and germacrone, in the C. aromatica extract were standardized to 0.64% and 1.12% w/w, respectively. The standardized extract (CAE) exerted cytotoxic effects on various cancer cells, whereas minimal effects at equivalent doses were noted for normal cells. CAE concentration-dependently suppressed growth of gastric cancer AGS cells via induction of apoptosis. Further studies revealed that CAE treatment disrupted mitochondrial membrane potential (ΔΨm), increased Bax/Bcl-2 ratio, and cytochrome c release, resulting in activation of caspase-9/-3 and subsequent cleavage of PARP. Further, the inhibitory effects of caspase-9/-3 expression by a synthetic pan-caspase inhibitor partially protected cells against apoptosis following CAE treatment. In addition, CAE significantly promoted cell death in AGS cells via an accumulation of cells in the G0/G1 phase. This effect was associated with upregulation of the CDK inhibitor p21 and downregulation of cyclin D1, cyclin E, CDK4, and CDK2 expression. Our data indicated that CAE exerted anti-proliferative activity by activating the mitochondria-mediated caspase-dependent apoptotic pathway and arresting the p21-mediated G0/G1 cell cycle on human gastric cancer AGS cells.

Human induced pluripotent stem cell-derived cardiomyocyte patches ameliorate right ventricular function in a rat pressure-overloaded right ventricle model.

Right ventricular (RV) failure following surgical repair of congenital heart disease affects survival. Human induced pluripotent stem cell-derived cardiomyocyte (hiPS-CM) sheet transplantation ameliorated left ventricular dysfunction in preclinical studies, indicating its efficacy in RV failure in congenital heart disease. This study aimed to evaluate whether hiPS-CMs could improve RV function in rats with pressure-overloaded RV failure. F344/NJcl-rnu/rnu rats underwent pulmonary artery banding (PAB) via left thoracotomy. Four weeks after PAB, hiPS-CM patch transplantation to the RV was performed in the hiPS-CM group (n = 33), and a sham operation was performed in the sham group (n = 18). We evaluated cardiac catheterization, positron emission tomography data, and pathological results 8weeks following PAB. RV end-diastolic pressure, the time constant of isovolumic relaxation, and end-diastolic pressure-volume relation were significantly ameliorated in the hiPS-CM group compared with in the sham group. Picrosirius red staining revealed that anti-fibrotic effects were significantly higher in the hiPS-CM group than in the sham group. Von Willebrand factor staining revealed significantly higher myocardial capillary vascular density in the hiPS-CM group than in the sham group. hiPS-CMs were detected in the epicardium 4weeks after hiPS-CM sheet transplantation. The angiogenic gene expression in the myocardium was significantly higher in the hiPS-CM group than in the sham group. Overall, in rats with pressure-overloaded RV failure, hiPS-CM patch transplantation could improve diastolic function, suppress ventricular fibrosis, and increase capillary density, suggesting that it is a promising treatment for RV failure.

Effectiveness of pulse oximetry as screening for congenital heart disease in newborns

Effectiveness of pulse oximetry as screening for congenital heart disease in newborns

Research progress on the relationship between free fatty acid profile and type 2 diabetes complicated by coronary heart disease

Research progress on the relationship between free fatty acid profile and type 2 diabetes complicated by coronary heart disease

Plasma microRNAs as Biomarkers for Predicting Radiotherapy Treatment-Induced Cardiotoxicity in Lung Cancer

Background: Lung cancer is the second most common malignancy and stands as a leading cause of cancer-related deaths worldwide. Currently, one of the main treatment options for lung cancer is radiotherapy, but this treatment is associated with complications, such as an increased risk of cardiac-related morbidity and mortality. However, currently available methods for predicting radiation-induced heart disease (RIHD) remain suboptimal. Methods: In this pilot study, using the RT-qPCR method, we analyzed the expression levels of six miRNAs (miRNA-1-3p, miRNA-21-5p, miRNA-24-3p, miRNA-29a-3p, miRNA-34a-5p, and miRNA-222-3p). Results: Fourteen pairs of locally advanced non-small-cell lung cancer patients’ plasma samples, taken before and after radiotherapy, were examined. It was observed that miRNA-1-3p, miRNA-21-5p, miRNA-24-3p, miRNA-29a-3p, and miRNA-222-3p were downregulated, while miRNA-34a-5p was upregulated in lung cancer patients’ plasma after treatment. Additionally, after definitive radiotherapy, patients with an increased NT-proBNP value displayed a statistically significant difference in miRNA-222-3p levels compared to the normal range of this indicator. The panel of the combined four miRNAs for assessing the risk of cardiac comorbidities demonstrated an AUC of 0.79, sensitivity of 71.43%, and specificity of 100%, with further improved values upon integration with clinical biomarker NT-proBNP. Conclusions: This pilot study shows that the identification of changes in miRNA expression levels in lung cancer patients’ plasma before and after radiotherapy could be used for the early diagnosis of RIHD.

Clinical manifestations and misdiagnosis factors of pulmonary embolism patients seeking treatment in cardiology.

To explore the clinical manifestations and factors leading to misdiagnosis in pulmonary embolism (PE) patients in a cardiology department. We retrospectively analyzed 74 patients diagnosed with PE at our hospital from March 2018 to March 2022, comparing them to 136 patients suspected of PE but excluded by computed tomography pulmonary angiography during the same period. Both groups received the same basic care, including disease counseling, nutritional planning, and monitoring. We compared general information, clinical manifestations, risk factors, and auxiliary examinations to identify correlations between specific manifestations and misdiagnosis factors. The male-to-female ratio in the PE group was approximately 3:4, which was statistically significant compared to the control group (P < .05), though its impact on PE incidence was low. Common symptoms in the PE group included chest tightness, shortness of breath, sweating, and chest pain, with no significant difference from the control group (P > .05). Notable risk factors included deep vein thrombosis (DVT) (43.24%), prolonged bed rest (32.43%), lower limb varicose veins (18.92%), trauma (21.62%), pulmonary infections (62.16%), coronary heart disease (37.84%), respiratory failure (32.43%), and chronic obstructive pulmonary disease (13.51%). DVT was significantly associated with PE (P < .05). Multivariate logistic regression identified DVT (OR = 118.528, 95% CI: 6.959-2018.906, P = .001) and lower limb varicose veins (OR = 212.766, 95% CI: 6.584-6875.950, P = .003) as independent predictive factors for suspected PE. Clinical manifestations strongly correlated with PE included pulmonary rales, cyanosis, tachycardia, hypotension, elevated D-dimer, positive N-terminal pro-brain natriuretic peptide, and sinus tachycardia on echocardiogram. PE in cardiology patients may present with pulmonary rales, hypotension, shortness of breath, and abdominal symptoms, warranting reexamination for PE. Misdiagnosis factors typically involve chest pain, tightness, and shortness of breath. Lower limb varicose veins and DVT are reliable predictors of suspected PE.

The Role of Dietary Magnesium in Cardiovascular Disease

In the past 20 years, a large number of epidemiological studies, randomized controlled trials, and meta-analyses have found an inverse relationship between magnesium intake or serum magnesium and cardiovascular disease, indicating that low magnesium status is associated with hypertension, coronary artery calcification, stroke, ischemic heart disease, atrial fibrillation, heart failure, and cardiac mortality. Controlled metabolic unit human depletion–repletion experiments found that a mild or moderate magnesium deficiency can cause physiological and metabolic changes that respond to magnesium supplementation, which indicates that these types of deficiencies or chronic latent magnesium deficiency are contributing factors to the occurrence and severity of cardiovascular disease. Mechanisms through which a mild or moderate magnesium deficiency can contribute to this risk include inflammatory stress, oxidative stress, dyslipidemia and deranged lipid metabolism, endothelial dysfunction, and dysregulation of cellular ion channels, transporters, and signaling. Based on USA official DRIs or on suggested modified DRIs based on body weight, a large number of individuals routinely consume less magnesium than the EAR. This especially occurs in populations that do not consume recommended amounts of whole grains, pulses, and green vegetables. Thus, inadequate magnesium status contributing to cardiovascular disease is widespread, making magnesium a nutrient of public health concern.

The effect of integrated medical care on the daily life of patients with coronary heart disease.

This study aims to explore the impact of comprehensive medical care on the daily life of patients with coronary heart disease (CHD) and to evaluate its effectiveness in improving quality of life, alleviating symptoms, and reducing the risk of cardiac events. A new comprehensive medical care scheme combining Traditional Chinese Medicine nursing differentiation, collaborative nursing interventions, and specialized community care was proposed. Patients with CHD were recruited as study subjects. Data were collected via questionnaires and interviews to assess the real-world impact of comprehensive medical care on the daily lives of patients. Significant improvements were observed in the observation group across multiple metrics. Baseline characteristics between the 2 groups showed no significant differences initially. Post-intervention, the observation group demonstrated significant improvements in left ventricular ejection fraction and self-assessment of stress (SAS), with left ventricular ejection fraction values increasing to 53.8% compared to 47.2% in the control group, and SAS scores decreasing markedly (P < .05). Additionally, the Disease Severity Index (DSI) indicated a significant reduction in disease severity in the observation group compared to a nonsignificant change in the control group (P > .05). Quality of life, assessed via MacNew and activities of daily living scores, also improved significantly post-intervention in the observation group compared to the control group (P < .05). Furthermore, the observation group exhibited a lower incidence of myocardial ischemia, myocardial infarction, and thrombosis over a 3-year period, with patient satisfaction significantly higher in the observation group (90% reported perfect contentment) compared to the control group (70% reported perfect contentment; P < .001). These findings suggest that the comprehensive nursing care approach significantly enhances cardiac function, quality of life, and patient satisfaction in CHD patients.

Prevalence and risk factors of cognitive frailty in patients with cardiovascular disease: A hospital-based cross-sectional study.

The prevalence of the cognitive frailty is increasing in China. Screening for this condition is crucial for its early detection, prevention, and treatment. This study was designed to explore the incidence of cognitive frailty among hospitalized elderly patients suffering from cardiovascular disease. It also aimed to analyze the factors influencing its occurrence, thereby providing substantial evidence for the development of early prevention and intervention strategies. From March 2022 to October 2023, under cardiovascular care program, the cardiovascular patients (n = 1190) were subjected to standardized questionnaires to collect demographical characteristics. Also, nutritional and psychosocial assessments tests were performed for the enrolled patients. Multivariate logistic regression analysis was used to evaluate factors associated with cognitive frailty. A total of 1190 (755 males and 435 females) were included. The mean age was 73.36 ± 7.37 years. The prevalence of cognitive frailty in the study population was 33.9% (404/1190). The prevalence of cognitive frailty was 40.7% in men, 22.3% in women. In terms of specific cardiovascular diseases, the prevalence of cognitive frailty was 28.5% in coronary heart disease, 20.5% in arrhythmia, 36.8% in valvular disease, 53% in heart failure, and 13.7% in hypertension. The multivariable analysis showed that age (OR = 1.13, 95% CI: 1.10-1.15, P < .001), anxiety (OR = 1.01, 95% CI: 1.03-1.11, P = .001), female sex (OR = 1.83, 95% CI: 1.10-1.16, P < .001), education level (college and above, OR = 0.27, OR = 0.12-0.64, P = .003), polypharmacy (OR = 2.29, 95% CI: 1.62-3.23, P < .001), comorbidity (OR = 1.93 95% CI: 1.37-2.71, P < .010), region (rural, OR = 1.77, 95% CI: 1.36-2.30, P < .001), sarcopenia (OR = 1.60, 95% CI: 1.16-2.19, P = .004), and nutritional status (risk of malnutrition, OR = 1.66, 95% CI: 1.17-2.35, P = .004; malnutrition exists, OR = 3.24, 95% CI: 1.85-5.83, P < .001) were independently associated with cognitive frailty. The prevalence of cognitive frailty was 33.9% in hospitalized elderly cardiovascular patients in Guangzhou. heart failure, hypertension, age, anxiety, female sex, education level, polypharmacy, comorbidity, region, sarcopenia, and nutritional status were independent risk factors for cognitive frailty.

Impact of pregnancy termination law reforms in Ireland on pregnancy termination rates in the setting of fetal congenital heart disease: A trend analysis.

Prior to 2019, termination of pregnancy (TOP) was unlawful in Ireland. We sought to examine the impact of legislative change on TOP for major congenital heart disease (CHD) and its effect on parental decision-making regarding the options of complex surgery, TOP, or palliative perinatal care. This was a trend analysis of second-trimester TOP for major CHD before and after the law reforms relating to pregnancy termination in Ireland. Retrospective data were collected on pregnancies complicated by major CHD at the largest tertiary referral obstetric center in Ireland from January 2017 to December 2023. Suspected CHD cases were referred to a dedicated fetal medicine/cardiology service. Major CHD was defined as an expected requirement for cardiac intervention in the first year of life. Genetic testing was performed where required, counseling was offered, and individualized care plans were developed. In a consecutive unselected cohort, 269 of 60 871 screened pregnancies fulfilled criteria for a diagnosis of major CHD. Major CHD was an isolated abnormality in 55% (147/269) of cases, while an extracardiac diagnosis was identified in 45% (162/269). TOP was chosen in 21% (16/76) of cases prior to legislative change and in 20% (39/193) of cases after legislative change (P = 0.158). The TOP rate was 8% (13/147) in isolated CHD cases, compared with 34% (42/122) in the setting of additional abnormalities (structural or genetic). We observed no difference in the rate of TOP for major CHD before and after TOP law reforms in Ireland on the grounds of fetal abnormality.

Causal association between cardiovascular risk factors and common skin diseases: A multivariate Mendelian randomization study.

Cardiovascular diseases and dermatological conditions are prevalent health issues worldwide. Previous studies have suggested that risk factors for cardiovascular diseases may be associated with the development of dermatological conditions. However, the causal association between these factors remain unclear. This study utilized data from genome-wide association studies and applied Mendelian randomization (MR) to explore the potential causal association between cardiovascular risk factors and common dermatological conditions. Genetic variants significantly associated with low-density lipoprotein cholesterol (LDL-C), serum uric acid, blood glucose, and hypertension were selected as instrumental variables. We employed inverse variance weighted, MR Egger, and weighted mode methods for analysis. Sensitivity analyses, including Cochran Q test, MR-Egger intercept test, MR-PRESSO global test, and leave-one-out analysis, were conducted to ensure the robustness of the results. The MR analysis indicated a positive association between LDL-C levels and the risk of psoriasis (odds ratio [OR] = 1.23, 95% confidence interval [CI]: 1.03-1.47, P = .02). Additionally, hypertension and serum uric acid levels were positively associated with the risk of dermatitis eczema (hypertension: OR = 2.77, 95% CI: 1.23-6.24, P = .01; serum uric acid: OR = 1.09, 95% CI: 1.01-1.06, P = .01). This study provides evidence of a potential causal association between LDL-C levels and psoriasis, as well as between hypertension and serum uric acid levels and dermatitis eczema. These findings highlight the potential importance of cardiovascular health management in the prevention and treatment of common dermatological conditions. Further research is needed to validate these results and explore the underlying biological mechanisms.

The Effects of a Grape Seed Procyanidin Extract on Cytochrome P450 3A4 Activity and Inflammatory Mediators in the Lungs of Heavy Active and Former Smokers

Grape seed procyanidin extract (GSE) is widely used to promote cardiovascular health and has purported anti-inflammatory properties. Chronic inflammation in the lungs caused by environmental toxins such as tobacco smoking plays a pivotal role in lung cancer development. In a modified phase I lung cancer chemoprevention study conducted in heavy active and former smokers using leucoselect phytosome (LP), a standardized grape seed procyanidin extract complexed with soy phospholipids to enhance bioavailability, three months of LP treatment favorably modulated a variety of surrogate endpoint biomarkers, including markers of cell proliferation. In this correlative study, we further analyzed the effects of LP on cytochrome P450 3A4 (CYP3A4) activities by comparing the endogenous conversions of cortisol and cortisone to 6-beta-hydroxycortisol and 6-beta-hydroxycortisone, respectively, before and after LP treatment and the anti-inflammatory effects of LP in the lung microenvironment of these participants by comparing a profile of inflammatory cytokines and chemokines in matched pre- and post-treatment bronchoalveolar lavage (BAL) fluids. LP treatment did not significantly alter CYP3A4 activity, and three months of LP treatment significantly decreased tumor necrosis factor (TNF), C-C Motif Chemokine Ligand 3 (CCL3) and granzyme B in BAL fluids. Furthermore, post-LP-treatment BAL fluids significantly reduced migration/invasion of various human lung neoplastic cells in vitro. Our findings support the anti-inflammatory effects of GSE/LP in the lung microenvironment and its potential utility for reducing cancerizing forces, as well as driving forces for other common respiratory diseases such as chronic obstructive pulmonary disease and asthma, in the lungs of heavy former and active smokers.