Pub Date : 2024-09-05DOI: 10.3389/fcvm.2024.1433807
Xinsheng Gu, Di Gao, Xinjian Zhou, Yueyou Ding, Wenrui Shi, Jieun Park, Shaohui Wu, Yue He
BackgroundMetabolic dysfunction associated steatotic liver disease (MASLD) contributes to the cardiometabolic diseases through multiple mechanisms. Fatty liver index (FLI) has been formulated as a non-invasive, convenient, and cost-effective approach to estimate the degree of MASLD. The current study aims to evaluate the correlation between FLI and the prevalent cardiometabolic multimorbidity (CMM), and to assess the usefulness of FLI to improve the detection of the prevalent CMM in the general population.Methods26,269 subjects were enrolled from the National Health and Nutrition Examination Survey 1999–2018. FLI was formulated based on triglycerides, body mass index, γ -glutamyltransferase, and waist circumference. CMM was defined as a history of 2 or more of diabetes mellitus, stroke, myocardial infarction.ResultsThe prevalence of CMM was 10.84%. With adjustment of demographic, anthropometric, laboratory, and medical history covariates, each standard deviation of FLI leaded to a 58.8% risk increase for the prevalent CMM. The fourth quartile of FLI had a 2.424 times risk for the prevalent CMM than the first quartile, and a trend towards higher risk was observed. Smooth curve fitting showed that the risk for prevalent CMM increased proportionally along with the elevation of FLI. Subgroup analysis demonstrated that the correlation was robust in several conventional subpopulations. Receiver-operating characteristic curve analysis revealed an incremental value of FLI for detecting prevalent CMM when adding it to conventional cardiometabolic risk factors (Area under the curve: 0.920 vs. 0.983, P < 0.001). Results from reclassification analysis confirmed the improvement from FLI.ConclusionOur study demonstrated a positive, linear, and robust correlation between FLI and the prevalent CMM, and our findings implicate the potential usefulness of FLI to improve the detection of prevalent CMM in the general population.
{"title":"Association between fatty liver index and cardiometabolic multimorbidity: evidence from the cross-sectional national health and nutrition examination survey","authors":"Xinsheng Gu, Di Gao, Xinjian Zhou, Yueyou Ding, Wenrui Shi, Jieun Park, Shaohui Wu, Yue He","doi":"10.3389/fcvm.2024.1433807","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1433807","url":null,"abstract":"BackgroundMetabolic dysfunction associated steatotic liver disease (MASLD) contributes to the cardiometabolic diseases through multiple mechanisms. Fatty liver index (FLI) has been formulated as a non-invasive, convenient, and cost-effective approach to estimate the degree of MASLD. The current study aims to evaluate the correlation between FLI and the prevalent cardiometabolic multimorbidity (CMM), and to assess the usefulness of FLI to improve the detection of the prevalent CMM in the general population.Methods26,269 subjects were enrolled from the National Health and Nutrition Examination Survey 1999–2018. FLI was formulated based on triglycerides, body mass index, γ -glutamyltransferase, and waist circumference. CMM was defined as a history of 2 or more of diabetes mellitus, stroke, myocardial infarction.ResultsThe prevalence of CMM was 10.84%. With adjustment of demographic, anthropometric, laboratory, and medical history covariates, each standard deviation of FLI leaded to a 58.8% risk increase for the prevalent CMM. The fourth quartile of FLI had a 2.424 times risk for the prevalent CMM than the first quartile, and a trend towards higher risk was observed. Smooth curve fitting showed that the risk for prevalent CMM increased proportionally along with the elevation of FLI. Subgroup analysis demonstrated that the correlation was robust in several conventional subpopulations. Receiver-operating characteristic curve analysis revealed an incremental value of FLI for detecting prevalent CMM when adding it to conventional cardiometabolic risk factors (Area under the curve: 0.920 vs. 0.983, <jats:italic>P</jats:italic> &lt; 0.001). Results from reclassification analysis confirmed the improvement from FLI.ConclusionOur study demonstrated a positive, linear, and robust correlation between FLI and the prevalent CMM, and our findings implicate the potential usefulness of FLI to improve the detection of prevalent CMM in the general population.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ObjectiveThis study strives to the variation and significance of microRNA-21 (miR-21) in children with congenital heart disease (CHD)-related pulmonary artery hypertension (PAH).MethodsChildren with CHD (n = 179) were selected as subjects, including 101 children without PAH and 78 children with PAH. All children underwent general data collection, laboratory examination, echocardiography and cardiac catheterization. After detection of serum miR-21 expression, the predictive value and the impacts of serum miR-21 for PAH and postoperative critical illness were analyzed.ResultsSerum creatine kinase isoenzyme (CK-MB), B-type natriuretic peptide (BNP) and miR-21 were elevated, but ejection fraction (EF) and cardiac index (CI) were decreased in the CHD-PAH group. Serum miR-21 assisted in predicting PAH in CHD children, with the area under curve (AUC) of 0.801 (95% CI of 0.735∼0.857), a cut-off value of 2.56, sensitivity of 73.08, and specificity of 72.28%. Serum miR-21 in children with CHD-PAH was correlated with clinicopathological indicators such as systolic pulmonary artery pressure, mean pulmonary arterial pressure, BNP and CI. Serum miR-21 helped predict the development of postoperative critical illness in children with CHD-PAH, with an AUC of 0.859 (95% CI: 0.762–0.927, cut-off value: 4.55, sensitivity: 69.57%, specificity: 92.73%). Increased serum miR-21 was an independent risk factor of postoperative critical illness in children with CHD-PAH.ConclusionSerum miR-21 was upregulated in children with CHD-PAH, which may serve as a predictive biomarker for the onset of PAH and postoperative critical illness in CHD children.
{"title":"Variation and significance of serum microRNA-21 level in pediatric pulmonary artery hypertension associated with congenital heart disease","authors":"Yanming Shen, Dongshan Liao, Wenlin Shangguan, Liangwan Chen","doi":"10.3389/fcvm.2024.1424679","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1424679","url":null,"abstract":"ObjectiveThis study strives to the variation and significance of microRNA-21 (<jats:italic>miR-21</jats:italic>) in children with congenital heart disease (CHD)-related pulmonary artery hypertension (PAH).MethodsChildren with CHD (<jats:italic>n</jats:italic> = 179) were selected as subjects, including 101 children without PAH and 78 children with PAH. All children underwent general data collection, laboratory examination, echocardiography and cardiac catheterization. After detection of serum <jats:italic>miR-21</jats:italic> expression, the predictive value and the impacts of serum <jats:italic>miR-21</jats:italic> for PAH and postoperative critical illness were analyzed.ResultsSerum creatine kinase isoenzyme (CK-MB), B-type natriuretic peptide (BNP) and <jats:italic>miR-21</jats:italic> were elevated, but ejection fraction (EF) and cardiac index (CI) were decreased in the CHD-PAH group. Serum <jats:italic>miR-21</jats:italic> assisted in predicting PAH in CHD children, with the area under curve (AUC) of 0.801 (95% CI of 0.735∼0.857), a cut-off value of 2.56, sensitivity of 73.08, and specificity of 72.28%. Serum <jats:italic>miR-21</jats:italic> in children with CHD-PAH was correlated with clinicopathological indicators such as systolic pulmonary artery pressure, mean pulmonary arterial pressure, BNP and CI. Serum <jats:italic>miR-21</jats:italic> helped predict the development of postoperative critical illness in children with CHD-PAH, with an AUC of 0.859 (95% CI: 0.762–0.927, cut-off value: 4.55, sensitivity: 69.57%, specificity: 92.73%). Increased serum <jats:italic>miR-21</jats:italic> was an independent risk factor of postoperative critical illness in children with CHD-PAH.ConclusionSerum <jats:italic>miR-21</jats:italic> was upregulated in children with CHD-PAH, which may serve as a predictive biomarker for the onset of PAH and postoperative critical illness in CHD children.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-04DOI: 10.3389/fcvm.2024.1481667
N Wilmes,A R Vrettou,S Lerakis,F W Asselbergs
{"title":"Editorial: Unravelling the reality of COVID-19 cardiovascular complications: true myocarditis vs. myocardial injury-the role of a multilayered approach.","authors":"N Wilmes,A R Vrettou,S Lerakis,F W Asselbergs","doi":"10.3389/fcvm.2024.1481667","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1481667","url":null,"abstract":"","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-04DOI: 10.3389/fcvm.2024.1468355
Lamiaa Ahmed,Naufal Zagidullin
{"title":"Editorial: Nutraceuticals in cardiovascular diseases and their associated risk conditions.","authors":"Lamiaa Ahmed,Naufal Zagidullin","doi":"10.3389/fcvm.2024.1468355","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1468355","url":null,"abstract":"","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-04DOI: 10.3389/fcvm.2024.1389109
Dohn Kissinger
{"title":"Are bacterial infections a major cause of cardiovascular disease?","authors":"Dohn Kissinger","doi":"10.3389/fcvm.2024.1389109","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1389109","url":null,"abstract":"","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AimsThis study aims to explore the different transition patterns and capture types during two bipolar pacing tests based on the selective left bundle branch (LBB) capture determined by the continuous pacing and recording technique.MethodsIn total, 67 patients completed two unipolar and two bipolar pacing tests based on selective LBB capture during screwing-in for left bundle branch pacing (LBBP) using the continuous pacing and recording technique. The electrophysiological characteristics and potential mechanisms of different pacing configurations were further evaluated in this study.ResultsWe found six transition patterns and derived seven capture types in two bipolar pacing tests according to the analysis of continuous electrocardiogram and electrogram changes. Compared with the conventional configuration of “Tip−Ring+” bipolar pacing, “Ring−Tip+” testing had a lower threshold for simultaneous capture of the LBB and the left and right ventricular septum myocardium (1.57 vs. 2.84 V at 0.5 ms) and was the only configuration to yield the peculiar “LBBP + right ventricular septum pacing (RVSP)” capture type.ConclusionsIn this study, we observed for the first time that “Ring−Tip+” bipolar pacing allows for a lower clinically applicable pacing threshold for simultaneous capture of the LBB and left and right ventricular septum myocardium, and the peculiar “LBBP + RVSP” capture type. This may be a more advantageous physiological pacing configuration, warranting further investigation and application in the future.Lay summaryBased on the specific selective LBB capture, we first found six transition patterns and derived seven capture types in two bipolar pacing tests due to the different thresholds of the LBB, left ventricular septal myocardial, and right ventricular septal myocardial. Compared with the conventional configuration of “Tip−Ring+” bipolar pacing, “Ring−Tip+” testing had a lower threshold for simultaneous capture of the LBB and the left and right ventricular septum myocardium (1.57 vs. 2.84 V at 0.5 ms) and was the only configuration to yield the peculiar “LBBP + RVSP” capture type. More pacing strategies should be released and investigated to achieve the best physiological pacing according to the individualized electrophysiological characteristics of patients.
目的 本研究旨在探讨基于连续起搏和记录技术确定的选择性左束支（LBB）捕获在两次双极起搏试验中的不同过渡模式和捕获类型。方法 共有67名患者在使用连续起搏和记录技术进行左束支起搏（LBBP）拧入时完成了基于选择性LBB捕获的两次单极和两次双极起搏试验。结果 根据对连续心电图和电图变化的分析，我们在两次双极起搏试验中发现了六种过渡模式，并得出了七种捕获类型。与传统的 "Tip-Ring+"双极起搏配置相比，"Ring-Tip+"测试同时捕获 LBB 和左右室间隔心肌的阈值较低（0.5 ms 时为 1.57 V vs. 2.84 V），并且是唯一能产生奇特的 "LBBP + 右室间隔起搏（RVSP）"捕获类型的配置。结论在这项研究中，我们首次观察到 "环尖+"双极起搏可使同时捕获 LBB 和左右室间隔心肌的临床适用起搏阈值更低，并可产生奇特的 "LBBP + RVSP "捕获类型。基于特定的选择性 LBB 捕获，我们首先在两个双极起搏试验中发现了六种过渡模式，并根据 LBB、左室间隔心肌和右室间隔心肌的不同阈值得出了七种捕获类型。与传统的 "Tip-Ring+"双极起搏配置相比，"Ring-Tip+"测试对同时捕获 LBB 和左右室间隔心肌的阈值较低（0.5 ms 时为 1.57 V 对 2.84 V），并且是唯一能产生奇特的 "LBBP + RVSP "捕获类型的配置。应根据患者的个体化电生理特点发布和研究更多起搏策略，以实现最佳生理起搏。
{"title":"Six transition patterns and seven capture types in different left bundle branch bipolar pacing configurations","authors":"Lu Zhang, Longfu Jiang, Binbin Luo, Jiabo Shen, Hao Wu, Weifang Zeng","doi":"10.3389/fcvm.2024.1430529","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1430529","url":null,"abstract":"AimsThis study aims to explore the different transition patterns and capture types during two bipolar pacing tests based on the selective left bundle branch (LBB) capture determined by the continuous pacing and recording technique.MethodsIn total, 67 patients completed two unipolar and two bipolar pacing tests based on selective LBB capture during screwing-in for left bundle branch pacing (LBBP) using the continuous pacing and recording technique. The electrophysiological characteristics and potential mechanisms of different pacing configurations were further evaluated in this study.ResultsWe found six transition patterns and derived seven capture types in two bipolar pacing tests according to the analysis of continuous electrocardiogram and electrogram changes. Compared with the conventional configuration of “Tip−Ring+” bipolar pacing, “Ring−Tip+” testing had a lower threshold for simultaneous capture of the LBB and the left and right ventricular septum myocardium (1.57 vs. 2.84 V at 0.5 ms) and was the only configuration to yield the peculiar “LBBP + right ventricular septum pacing (RVSP)” capture type.ConclusionsIn this study, we observed for the first time that “Ring−Tip+” bipolar pacing allows for a lower clinically applicable pacing threshold for simultaneous capture of the LBB and left and right ventricular septum myocardium, and the peculiar “LBBP + RVSP” capture type. This may be a more advantageous physiological pacing configuration, warranting further investigation and application in the future.Lay summaryBased on the specific selective LBB capture, we first found six transition patterns and derived seven capture types in two bipolar pacing tests due to the different thresholds of the LBB, left ventricular septal myocardial, and right ventricular septal myocardial. Compared with the conventional configuration of “Tip−Ring+” bipolar pacing, “Ring−Tip+” testing had a lower threshold for simultaneous capture of the LBB and the left and right ventricular septum myocardium (1.57 vs. 2.84 V at 0.5 ms) and was the only configuration to yield the peculiar “LBBP + RVSP” capture type. More pacing strategies should be released and investigated to achieve the best physiological pacing according to the individualized electrophysiological characteristics of patients.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-03DOI: 10.3389/fcvm.2024.1449506
Désirée Carmine, Stefanie Aeschbacher, Michael Coslovsky, Elisa Hennings, Rebecca E. Paladini, Raffaele Peter, Melanie Burger, Tobias Reichlin, Nicolas Rodondi, Andreas S. Müller, Peter Ammann, Giulio Conte, Angelo Auricchio, Giorgio Moschovitis, Julia B. Bardoczi, Annina Stauber, Maria Luisa De Perna, Christine S. Zuern, Tim Sinnecker, Patrick Badertscher, Christian Sticherling, Leo H. Bonati, David Conen, Philipp Krisai, Stefan Osswald, Michael Kühne
BackgroundThe influence of atrial fibrillation (AF) and blood pressure (BP) on brain lesions and cognitive function is unclear. We aimed to investigate the association of BP with different types of brain lesions and cognitive decline in patients with AF.MethodsOverall, 1,213 AF patients underwent standardized brain magnetic resonance imaging at baseline and after 2 years, as well as yearly neurocognitive testing. BP was measured at baseline and categorized according to guidelines. New lesions were defined as new or enlarged brain lesions after 2 years. We defined cognitive decline using three different neurocognitive tests. Logistic and Cox regression analyses were performed to examine the associations of BP with new brain lesions and cognitive decline.ResultsThe mean age was 71 ± 8.4 years, 74% were male and mean BP was 135 ± 18/79 ± 12 mmHg. New ischemic lesions and white matter lesions were found in 5.4% and 18.4%, respectively. After multivariable adjustment, BP was not associated with the presence of new brain lesions after 2 years. There was no association between BP and cognitive decline over a median follow-up of 6 years when using the Montreal Cognitive Assessment or Digit Symbol Substitution Test. However, BP categories were inversely associated with cognitive decline using the Semantic Fluency Test, with the strongest association in patients with hypertension grade 1 [Hazard Ratio (95% Confidence Interval) 0.57(0.42 to 0.77)], compared to patients with optimal BP (p for linear trend: 0.025).ConclusionsIn a large cohort of AF patients, there was no association between BP and incidence of brain lesions after 2 years. Also, there was no consistent association between BP and cognitive decline over a follow-up of 6 years.Clinical Trial Registrationhttps://clinicaltrials.gov/study/NCT02105844, Identifier (NCT02105844).
{"title":"Blood pressure, brain lesions and cognitive decline in patients with atrial fibrillation","authors":"Désirée Carmine, Stefanie Aeschbacher, Michael Coslovsky, Elisa Hennings, Rebecca E. Paladini, Raffaele Peter, Melanie Burger, Tobias Reichlin, Nicolas Rodondi, Andreas S. Müller, Peter Ammann, Giulio Conte, Angelo Auricchio, Giorgio Moschovitis, Julia B. Bardoczi, Annina Stauber, Maria Luisa De Perna, Christine S. Zuern, Tim Sinnecker, Patrick Badertscher, Christian Sticherling, Leo H. Bonati, David Conen, Philipp Krisai, Stefan Osswald, Michael Kühne","doi":"10.3389/fcvm.2024.1449506","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1449506","url":null,"abstract":"BackgroundThe influence of atrial fibrillation (AF) and blood pressure (BP) on brain lesions and cognitive function is unclear. We aimed to investigate the association of BP with different types of brain lesions and cognitive decline in patients with AF.MethodsOverall, 1,213 AF patients underwent standardized brain magnetic resonance imaging at baseline and after 2 years, as well as yearly neurocognitive testing. BP was measured at baseline and categorized according to guidelines. New lesions were defined as new or enlarged brain lesions after 2 years. We defined cognitive decline using three different neurocognitive tests. Logistic and Cox regression analyses were performed to examine the associations of BP with new brain lesions and cognitive decline.ResultsThe mean age was 71 ± 8.4 years, 74% were male and mean BP was 135 ± 18/79 ± 12 mmHg. New ischemic lesions and white matter lesions were found in 5.4% and 18.4%, respectively. After multivariable adjustment, BP was not associated with the presence of new brain lesions after 2 years. There was no association between BP and cognitive decline over a median follow-up of 6 years when using the Montreal Cognitive Assessment or Digit Symbol Substitution Test. However, BP categories were inversely associated with cognitive decline using the Semantic Fluency Test, with the strongest association in patients with hypertension grade 1 [Hazard Ratio (95% Confidence Interval) 0.57(0.42 to 0.77)], compared to patients with optimal BP (p for linear trend: 0.025).ConclusionsIn a large cohort of AF patients, there was no association between BP and incidence of brain lesions after 2 years. Also, there was no consistent association between BP and cognitive decline over a follow-up of 6 years.Clinical Trial Registration<jats:uri>https://clinicaltrials.gov/study/NCT02105844</jats:uri>, Identifier (NCT02105844).","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-03DOI: 10.3389/fcvm.2024.1481893
Daniel A Gomes,Teresa Strisciuglio,Alexandre Almorad,Serge Boveda,Rui Providência
{"title":"Editorial: Atrial fibrillation: selection of management strategy and evaluation of outcomes.","authors":"Daniel A Gomes,Teresa Strisciuglio,Alexandre Almorad,Serge Boveda,Rui Providência","doi":"10.3389/fcvm.2024.1481893","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1481893","url":null,"abstract":"","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-03DOI: 10.3389/fcvm.2024.1333684
Yongzhe Guo, Tao Lin, Nanyu Lin, Huizhong Lin
BackgroundVasovagal syncope (VVS) is a prevalent medical condition with a lack of efficient methods for its detection.AimThis study aimed to explore an objective clinical indicator in diagnosing VVS.MethodsThe retrospective analysis involved clinical data of 243 syncope patients from 1 June 2020 to 31 July 2023. Among them, 108 patients had a negative result in the tilt test (TTT), while the remaining 135 patients had a positive result in the TTT. Relevant statistical methods were utilized to examine the correlation between VVS and different indicators of heart rate variability.ResultsAfter screening, 354 patients being considered for VVS were evaluated, resulting in a final sample size of 243. Sex, age, deceleration capacity (DC), and standard deviation of all normal-to-normal intervals (SDNNs) were the variables that showed statistical significance between the TTT(−) group and the TTT(+) group. Independent risk factors identified by multivariate logistic regression were DC [odds ratio (OR) 1.710, 95% confidence interval (CI) 1.388–2.106, P < 0.001] and SDNN (OR 1.033, 95% CI 1.018–1.049, P < 0.001). Comparing the groups, receiver operating characteristic analysis revealed a notable distinction in both DC and SDNN [the respective areas under the curve were 0.789 (95% CI 0.730–0.848) and 0.702 (95% CI 0.637–0.767); the cutoff values were 7.15 and 131.42; P < 0.001, respectively].ConclusionIn summary, DC can function as an impartial and easily accessible clinical marker for differentiating VVS. A value exceeding 7.15 ms might suggest a higher likelihood of syncope.
背景血管迷走性晕厥（VVS）是一种普遍存在的内科疾病，目前缺乏有效的检测方法。其中，108 例患者倾斜试验（TTT）结果为阴性，其余 135 例患者倾斜试验结果为阳性。结果经过筛查，评估了 354 名考虑进行 VVS 的患者，最终样本量为 243 人。性别、年龄、减速能力（DC）和所有正常至正常间期的标准偏差（SDNNs）是在 TTT（-）组和 TTT（+）组之间显示出统计学意义的变量。多变量逻辑回归确定的独立风险因素是 DC [几率比（OR）1.710，95% 置信区间（CI）1.388-2.106，P < 0.001]和 SDNN（OR 1.033，95% CI 1.018-1.049，P < 0.001）。比较各组，接收器操作特征分析显示 DC 和 SDNN 均有显著差异[曲线下面积分别为 0.789 (95% CI 0.730-0.848) 和 0.702 (95% CI 0.637-0.767); 临界值分别为 7.15 和 131.42; P < 0.001]。超过 7.15 毫秒的数值可能表明晕厥的可能性较高。
{"title":"Effectiveness analysis of deceleration capacity and traditional heart rate variability in diagnosing vasovagal syncope","authors":"Yongzhe Guo, Tao Lin, Nanyu Lin, Huizhong Lin","doi":"10.3389/fcvm.2024.1333684","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1333684","url":null,"abstract":"BackgroundVasovagal syncope (VVS) is a prevalent medical condition with a lack of efficient methods for its detection.AimThis study aimed to explore an objective clinical indicator in diagnosing VVS.MethodsThe retrospective analysis involved clinical data of 243 syncope patients from 1 June 2020 to 31 July 2023. Among them, 108 patients had a negative result in the tilt test (TTT), while the remaining 135 patients had a positive result in the TTT. Relevant statistical methods were utilized to examine the correlation between VVS and different indicators of heart rate variability.ResultsAfter screening, 354 patients being considered for VVS were evaluated, resulting in a final sample size of 243. Sex, age, deceleration capacity (DC), and standard deviation of all normal-to-normal intervals (SDNNs) were the variables that showed statistical significance between the TTT(−) group and the TTT(+) group. Independent risk factors identified by multivariate logistic regression were DC [odds ratio (OR) 1.710, 95% confidence interval (CI) 1.388–2.106, <jats:italic>P</jats:italic> &lt; 0.001] and SDNN (OR 1.033, 95% CI 1.018–1.049, <jats:italic>P</jats:italic> &lt; 0.001). Comparing the groups, receiver operating characteristic analysis revealed a notable distinction in both DC and SDNN [the respective areas under the curve were 0.789 (95% CI 0.730–0.848) and 0.702 (95% CI 0.637–0.767); the cutoff values were 7.15 and 131.42; <jats:italic>P</jats:italic> &lt; 0.001, respectively].ConclusionIn summary, DC can function as an impartial and easily accessible clinical marker for differentiating VVS. A value exceeding 7.15 ms might suggest a higher likelihood of syncope.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-03DOI: 10.3389/fcvm.2024.1449480
Yuchen Shen, Qianyun Han, Deming Wang, Lixin Su, Mingzhe Wen, Xindong Fan, Xitao Yang
PurposeThis study aimed to evaluate the efficacy and safety of ethanol embolization in treating traumatic arteriovenous fistulas (TAVFs).Materials and methodsFrom March 2012 to April 2020, 42 consecutive patients (29.9 ± 15.1 years, range: 3–68 years) with peripheral TAVFs underwent ethanol embolization. All patients underwent clinical and imaging follow-ups (40.0 ± 25.9 months, range: 3–90 months). The mean time to onset of symptoms after trauma was 5.4 ± 5.9 months (range: 0.5–30 months). Among the patients, 27 (64.3%) reported that the TAVFs occurred after blunt trauma, 10 (23.8%) presented after penetrating trauma (with 4 patients involving penetration by infusion indwelling needles), and 3 (7.1%) had a history of surgery. Treatment effects, devascularization rates, and complications were evaluated at follow-ups conducted at 1–3 month intervals.ResultsSeventy-one embolization procedures were performed, with a mean of 1.6 ± 0.7 procedures per patient. Thirty-four patients received coil-assisted ethanol embolization. Absolute ethanol was used in all procedures, with an average volume of 7.1 ± 4.2 ml per procedure (range: 1–18 ml); 28 patients (28/42, 66.7%) received coil embolization in 36 procedures (36/71, 50.7%). Upon re-examination, 39 patients (92.9%) achieved 100% devascularization; of these, 29 patients (74.4%) with Schobinger stage II TAVFs improved to stage I or became asymptomatic. Overall, 30 cases (66.7%) achieved a complete response, while the other 12 cases (33.3%) showed a partial response. In addition, no major complications were observed postoperatively, apart from minor complications.ConclusionsCoil-assisted ethanol embolization can effectively manage TAVFs with an acceptable risk of mild complications.
{"title":"Coil-assisted ethanol embolization of traumatic arteriovenous fistulas: a 10-year retrospective study","authors":"Yuchen Shen, Qianyun Han, Deming Wang, Lixin Su, Mingzhe Wen, Xindong Fan, Xitao Yang","doi":"10.3389/fcvm.2024.1449480","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1449480","url":null,"abstract":"PurposeThis study aimed to evaluate the efficacy and safety of ethanol embolization in treating traumatic arteriovenous fistulas (TAVFs).Materials and methodsFrom March 2012 to April 2020, 42 consecutive patients (29.9 ± 15.1 years, range: 3–68 years) with peripheral TAVFs underwent ethanol embolization. All patients underwent clinical and imaging follow-ups (40.0 ± 25.9 months, range: 3–90 months). The mean time to onset of symptoms after trauma was 5.4 ± 5.9 months (range: 0.5–30 months). Among the patients, 27 (64.3%) reported that the TAVFs occurred after blunt trauma, 10 (23.8%) presented after penetrating trauma (with 4 patients involving penetration by infusion indwelling needles), and 3 (7.1%) had a history of surgery. Treatment effects, devascularization rates, and complications were evaluated at follow-ups conducted at 1–3 month intervals.ResultsSeventy-one embolization procedures were performed, with a mean of 1.6 ± 0.7 procedures per patient. Thirty-four patients received coil-assisted ethanol embolization. Absolute ethanol was used in all procedures, with an average volume of 7.1 ± 4.2 ml per procedure (range: 1–18 ml); 28 patients (28/42, 66.7%) received coil embolization in 36 procedures (36/71, 50.7%). Upon re-examination, 39 patients (92.9%) achieved 100% devascularization; of these, 29 patients (74.4%) with Schobinger stage II TAVFs improved to stage I or became asymptomatic. Overall, 30 cases (66.7%) achieved a complete response, while the other 12 cases (33.3%) showed a partial response. In addition, no major complications were observed postoperatively, apart from minor complications.ConclusionsCoil-assisted ethanol embolization can effectively manage TAVFs with an acceptable risk of mild complications.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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