Heart failure (HF) is a complex and multifactorial syndrome with high morbidity and mortality rates worldwide. Accumulative evidence suggests that microRNAs (miRNAs) play critical roles in maintaining cardiac homeostasis. The dysregulation of various miRNAs has been reported in different studies on failing human hearts. However, little is known about their circulatory profile. In this study, comprehensive miRNA profiling was performed by next-generation sequencing for plasma samples of 24 HF and 24 age and sex-matched, non-HF patients. A total of 1391 miRNAs were detected, of which 228 miRNAs and 261 miRNAs were commonly expressed in the HF and non-HF groups, respectively. Eight miRNAs (hsa-let-7b-3p, hsa-miR-92b-5p, hsa-miR-145-3p, hsa-miR-206, hsa-miR-664a-5p, hsa-miR-1307-5p, hsa-miR-1908-5p, and hsa-miR-3074-5p) were found to be dysregulated between HF and non-HF patients. The expression of another seven miRNAs (hsa-miR-589-5p, hsa-miR-30b-5p, hsa-miR-654-3p, hsa-miR-1292-5p, hsa-miR-659-5p, hsa-miR-548d-5p, and hsa-miR-7847-3p) was frequently observed in HF patients but not in non-HF cases. Subsequent analyses of target gene prediction and associated pathways revealed the enrichment of pathways related to vascular development, the cell cycle, and transcriptional activity. These data reveal the expression profile and the dysregulation of circulating miRNAs in our patients with HF.

Unusual clinical course Since the initial COVID-19 cases in 2019, the pandemic has expanded globally. Clinical data showed that dexamethasone treatment at a dose of 6 mg daily for up to 10 days in hospitalized patients with COVID-19 who were receiving respiratory support decreased 28-day mortality in COVID-19 patients. Recent reports, on the other hand, have indicated that both steroid resistance and rebound events occur. We report a case of rebound inflammation after the termination of dexamethasone medication in a 38-year-old man with severe COVID-19 pneumonia, which improved after the reintroduction of dexamethasone. A 38-year-old male patient with no past medical history of note presented with new onset of dyspnea. He was subsequently diagnosed with severe coronavirus disease 2019 (COVID-19). Initially, the patient was clinically improved following a 3-day course of 16 mg of dexamethasone daily. Shortly after discontinuing corticosteroids, the patient’s clinical condition deteriorated, necessitating increased oxygen support. Following the rein-troduction of corticosteroids, the patient gradually improved and responded favorably in terms of respiratory function, symptoms, and imaging, after which he was successfully discharged. This case exemplifies the previously observed rebound effects of discontinuing dexamethasone medication in individuals with severe COVID-19 pneumonia. The timing and length of dexamethasone medication should be tailored to the individual patient. In addition, monitoring lung function should be part of the gradual withdrawal of dexamethasone to avoid rebound lung inflammation and the long-term effects of increasing lung fibrosis.

Introduction: Significant advances have been made in the diagnosis and treatment of coronary artery disease over the years. New generations of scaffolds containing novel material and eluting drug have produced one of the most significant advancements in coronary intervention. The newest generation would be Magmaris with a magnesium frame and a sirolimus cover.Methods: From July 2018 to August 2020, 58 patients treated with Magmaris at the University Medical Center Ho Chi Minh City were enrolled in this study.Results: A total of 60 lesions were stented, 60.3% of which were left anterior descending (LAD) lesions. There was no in-hospital event. Within 1 year after discharge, we noted one myocardial infarction event that required target-lesion revascularization, one stroke event, one non-target-lesion revascularization patient, two target-vessel revascularization patients, and one in-stent thrombosis. Among them, one myocardial infarction occurrence, one non-target-lesion revascularization, and one in-stent thrombosis event were recorded within the first 30 days after discharge.Conclusion: In conclusion, the Magmaris scaffold is a safe and effective option for structural procedures performed with imaging device support, particularly intravascular ultrasound.

Although guideline-directed medical therapy (GDMT) improves outcomes in patients with heart failure with reduced ejection fraction (HFrEF), multiple real-world studies - such as CHAMP-HF (USA) and ASIAN-HF (Asia-Pacific) - have reported that a large proportion of patients fail to reach target doses. This global gap between recommendations and practice highlights the need to better understand country-specific barriers, particularly in low- and middle-income settings such as Vietnam. This cross-sectional study included adult outpatients diagnosed with HFrEF who had received at least three months of continuous therapy at the Heart Failure Clinic, University Medical Center Ho Chi Minh City, between February and August 2023, and aimed to (1) determine the prevalence of use, (2) evaluate typical dosages, and (3) examine the sequence of initiation of foundational therapies in this population. Among 181 patients, 98.9% were prescribed at least one foundational drug class, and 74.6% received all four classes. Patients who did not receive all four therapies were typically older females with higher systolic blood pressure and reduced renal function. SGLT2 inhibitors and MRAs had the highest rates of target dose achievement, whereas ARNI and beta-blockers were more frequently underdosed. Dose escalation was commonly limited by hypotension, advanced age, renal impairment, and low body weight. Notably, 82% of patients were initiated on three or four drug classes concurrently at the start of treatment, most commonly including RAS inhibitors, MRAs, and beta-blockers, with a preference for ARNI over ACE inhibitors or ARBs. Foundational therapies were widely prescribed and frequently initiated concurrently in the management of HFrEF at a tertiary care hospital in Vietnam. However, achieving target doses remains a challenge, highlighting the gap between clinical guidelines and real-world practice due to factors such as low blood pressure, advanced age, and renal dysfunction.

Prolonged anaphylaxis, especially symptoms that last several days, can lead to misdiagnosis and delays in treatment, especially when patients present with