International Journal of Cardiology Cardiovascular Risk and Prevention最新文献_第2页

Sex-specific anatomical challenges in TAVR: A closer look at bicuspid aortic valve stenosis TAVR的性别特异性解剖学挑战：二尖瓣主动脉瓣狭窄的进一步研究

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2026-06-01 Epub Date: 2026-02-03 DOI: 10.1016/j.ijcrp.2026.200591

Pingjun Huang , Chu Liu , Jiameng Li , Lei Li , Yongquan Sun , Jiqiang Bu , Yu Liu , Tengyue Zhao

Background

This paper seeks to examine the findings of the recently published study by Gitto et al., titled "Clinical Outcomes in Women and Men with Raphe-Type Bicuspid Aortic Valve Stenosis Undergoing Transcatheter Aortic Valve Replacement," and to conduct a further analysis of the potential influencing factors.

Methods

A critical analysis was conducted on this published multicenter registry study, with a focus on the finding that female patients have a higher risk of valve migration after transcatheter aortic valve replacement (TAVR). In-depth discussions were carried out from the perspectives of sex-related anatomical differences of the aorta and device selection.

Results

The original study indicated that female patients have a higher risk of post-TAVR valve migration and a lower technical success rate. This analysis suggests that, in addition to the factors mentioned in the original study (e.g., more frequent use of self-expandable valves and intra-annular downsizing), female-specific anatomical characteristics—such as a more horizontal aortic angle, more significant vascular tortuosity, and smaller iliac artery diameter—may jointly affect device delivery, positioning, and release stability, thereby contributing to such outcome disparities. Furthermore, it is recommended that the original study data be further analyzed to evaluate the impact of different types of self-expandable valves (e.g., ACURATE neo2) on valve positioning.

Conclusion

In patients with raphe-type bicuspid aortic valve stenosis, sex-related anatomical variations and device selection discrepancies are important factors affecting TAVR outcomes. Future research and technological development should fully take these factors into account to achieve more personalized treatment strategies.

本文旨在检查Gitto等人最近发表的题为“经导管主动脉瓣置换术治疗raphe型双尖瓣主动脉瓣狭窄的男女临床结果”的研究结果，并进一步分析潜在的影响因素。方法对已发表的多中心注册研究进行批判性分析，重点关注经导管主动脉瓣置换术（TAVR）后女性患者瓣膜移位风险较高的发现。从主动脉的性别解剖差异、器械选择等方面进行了深入探讨。结果原始研究表明，女性患者tavr后瓣膜移位的风险较高，技术成功率较低。该分析表明，除了原始研究中提到的因素（如更频繁地使用自膨胀瓣膜和环内缩小）外，女性特有的解剖特征（如主动脉角度更水平、血管扭曲更明显、髂动脉直径更小）可能共同影响装置的输送、定位和释放稳定性，从而导致这种结果差异。此外，建议进一步分析原始研究数据，以评估不同类型的自膨胀阀（如accurate neo2）对阀门定位的影响。结论在raphe型双尖瓣主动脉瓣狭窄患者中，性别相关的解剖差异和器械选择差异是影响TAVR预后的重要因素。未来的研究和技术发展应充分考虑这些因素，以实现更个性化的治疗策略。

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引用次数: 0

Renal denervation in 2025: long-term evidence supporting sympathetic modulation as a durable strategy for uncontrolled hypertension 2025年肾去神经：长期证据支持交感调节作为控制高血压的持久策略

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2026-06-01 Epub Date: 2026-02-02 DOI: 10.1016/j.ijcrp.2026.200587

Dominique Stephan , Emma Morisot , François Bronner , Eric Prinz , Mihaela Calcaianu , Elena-Mihaela Cordeanu

Background

Renal denervation (RDN) has emerged as a promising device-based therapy for uncontrolled hypertension. Recent data from major cardiovascular conferences (EuroPCR, ESH, TCT 2025) provide unprecedented 3-year follow-up evidence on efficacy, safety, and clinical outcomes.

Methods

We synthesize key findings from the SPYRAL HTN-ON MED 3-year final report, the Global Symplicity Registry DEFINE (GSR-DEFINE) real-world data, SPYRAL AFFIRM post-approval study, and pooled analyses on acute hypertensive events. Data sources are distiguisehed by level of evidence: randomized sham-controlled trials versus observational registry data.

Results

At 3 years, SPYRAL HTN-ON MED demonstrated sustained office systolic blood pressure (SBP) reductions of −18.5 mmHg (RDN) versus −11.7 mmHg (sham), with treatment difference of −6.8 mmHg (p = 0.0002). The GSR-DEFINE registry (n = 3109) showed −20.5 mmHg office SBP reduction at 3 years with progressively increasing effect over time. Pooled analysis revealed a 43% reduction in acute hypertensive events with RDN. No renal artery stenosis or need for reintervention was observed through 3 years.

Conclusion

These data support RDN as a potentially durable and safe adjunctive therapy for uncontrolled hypertension in appropriately selected patients. Benefits appear to extend to high-risk populations including patients with diabetes, chronic kidney disease, and prior stroke, though long-term cardiovascular outcome data remain awaited.

背景：肾去神经支配（RDN）已成为一种很有前途的基于设备的治疗高血压的方法。来自主要心血管会议（EuroPCR、ESH、TCT 2025）的最新数据提供了前所未有的关于疗效、安全性和临床结果的3年随访证据。方法：我们综合了SPYRAL HTN-ON MED 3年最终报告、GSR-DEFINE（全球复杂性注册定义）真实数据、SPYRAL AFFIRM批准后研究以及急性高血压事件汇总分析的主要发现。数据来源按证据水平区分：随机假对照试验与观察性注册数据。结果3年后，SPYRAL HTN-ON MED显示持续办公室收缩压（SBP）降低- 18.5 mmHg （RDN）与- 11.7 mmHg (sham)，治疗差异为- 6.8 mmHg （p = 0.0002）。GSR-DEFINE注册表（n = 3109）显示，3年后办公室收缩压降低- 20.5 mmHg，随着时间的推移，效果逐渐增强。综合分析显示，RDN可减少43%的急性高血压事件。3年内未观察到肾动脉狭窄或需要再干预。结论：这些数据支持RDN作为一种潜在的持久和安全的辅助治疗，用于适当选择的不受控制的高血压患者。益处似乎延伸到高风险人群，包括糖尿病、慢性肾病和既往中风患者，尽管长期心血管结果数据仍有待等待。

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引用次数: 0

Comment on “Dose-dependent effects of SGLT2 inhibitors on circadian blood pressure in hypertensive patients with diabetes: A systematic review and Bayesian network meta-analysis” 《SGLT2抑制剂对高血压糖尿病患者昼夜血压的剂量依赖性作用：一项系统综述和贝叶斯网络meta分析》

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2026-06-01 Epub Date: 2026-02-10 DOI: 10.1016/j.ijcrp.2026.200597

Yin Jian , Bin Cao

引用次数: 0

Global burden and cross-country inequalities of alcoholic cardiomyopathy: A 1990–2021 analysis 酒精性心肌病的全球负担和跨国不平等：1990-2021年分析

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2026-03-01 Epub Date: 2025-12-15 DOI: 10.1016/j.ijcrp.2025.200561

Mingze Zheng , Chuang Sun , Ming Li , Hongwei Xiang , He Ren , Jin Cheng

Introduction

Alcoholic cardiomyopathy (ACM) remains a significant yet understudied contributor to global cardiovascular disease, with substantial socioeconomic influences on its epidemiology. This study investigates the global burden, temporal trends, and health inequalities of ACM across 204 countries.

Methods

Utilizing the Global Burden of Disease 2021 data (1990–2021), we analyzed age-standardised mortality (ASMR), prevalence (ASPR), and disability-adjusted life years (ASDR) for populations aged ≥15 years. A trend analysis employed the estimated annual percentage change (EAPC), while inequality metrics (Slope Index of Inequality, Concentration Index) assessed socioeconomic disparities using the socio-demographic index (SDI).

Results

Globally, ACM caused 47,073 deaths and 2.19 million DALYs in 2021, with an overall decreasing trend (ASMR EAPC: −1.72 %). High-middle SDI regions bore the highest burden (ASDR: 88.27/100,000), particularly Eastern Europe (ASDR: 510.47). We identified a distinct nonlinear relationship with SDI: burden peaked at SDI≈0.75 (p < 0.001), with Eastern Europe showing the steepest rise/decline. Inequality analysis revealed persistent concentration in high-SDI regions (positive concentration indices: 0.51–0.60), though relative inequalities decreased over time. Kazakhstan exhibited the most rapid burden increase (ASMR EAPC: +11.15 %), while Southern Latin America showed maximal decline (ASMR EAPC: −6.69 %).

Conclusions

ACM disparities are strongly linked to socioeconomic development, highlighting the need for targeted alcohol policies in high-burden regions and equitable healthcare resource allocation.

酒精性心肌病（ACM）仍然是全球心血管疾病的一个重要但尚未得到充分研究的因素，其流行病学具有重大的社会经济影响。本研究调查了204个国家的全球负担、时间趋势和ACM的健康不平等。方法利用全球疾病负担2021数据（1990-2021），分析年龄≥15岁人群的年龄标准化死亡率（ASMR）、患病率（ASPR）和残疾调整生命年（ASDR）。趋势分析采用估计的年百分比变化（EAPC），而不平等指标（不平等斜率指数，集中指数）使用社会人口指数（SDI）评估社会经济差异。结果在全球范围内，2021年ACM导致47073人死亡，219万DALYs，总体呈下降趋势（ASMR EAPC: - 1.72%）。中高SDI地区负担最重（ASDR: 88.27/10万），特别是东欧（ASDR: 510.47）。我们发现了与SDI之间明显的非线性关系：负担在SDI≈0.75时达到峰值（p < 0.001），东欧表现出最急剧的上升/下降。不平等分析显示，尽管相对不平等随着时间的推移而减少，但高sdi地区的浓度持续存在（阳性浓度指数：0.51-0.60）。哈萨克斯坦的负担增长最快（ASMR EAPC: + 11.15%），而拉丁美洲南部的负担下降最快（ASMR EAPC: - 6.69%）。结论sacm差异与社会经济发展密切相关，强调高负担地区需要有针对性的酒精政策和公平的医疗资源分配。

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引用次数: 0

Life’s Essential 8 and cardiovascular health: Protective effects on chronic respiratory diseases 生命必需品和心血管健康：对慢性呼吸系统疾病的保护作用

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2026-03-01 Epub Date: 2025-12-24 DOI: 10.1016/j.ijcrp.2025.200567

Jianli Ma , Xiyu Cao , Zhipeng Ma , Xiao Liu , Hualing Wang , Ke Liu , Xinyu Li , Chuantao Zhang

Background

Chronic respiratory diseases (CRDs) pose a global health challenge. While individual lifestyle factors are known to influence CRDs risk, the collective role of comprehensive cardiovascular health (CVH) metrics remains less clear. Life’s Essential 8 (LE8) provides a holistic measure of CVH, but its association with CRDs and related mortality is not well-established at the population level.

Methods

The observational study was based on the US National Health and Nutrition Examination Survey (NHANES 2007–2018). We adjusted for confounding factors and used survey-weighted logistic regression analysis to assess the association between LE8 and the risk of CRDs and the subtypes. Restricted cubic splines (RCS) evaluated non-linear relationships. Subgroup and sensitivity analyses were also conducted. Cox models investigated LE8’s impact on all-cause and chronic lower respiratory diseases (CLRDs) mortality.

Results

The observational study included 30,863 participants. After adjusting for confounders, survey-weighted logistic regression demonstrates a negative association between LE8 and the risk of CRDs and the four subtypes, with emphysema showing the most significant association (OR = 0.96, 95 % CI: 0.95, 0.97, P < 0.001). RCS suggests a non-linear relationship between LE8 and CRDs. Subgroup and sensitivity analyses confirm the robustness of the results. Compared to individuals with low CVH, those with high CVH have lower risks of all-cause mortality and CLRDs mortality (HR = 0.82, 95 % CI: 0.71, 0.93, P = 0.003; HR = 0.27, 95 % CI: 0.08, 0.88, P = 0.030).

Conclusion

LE8 inversely correlates with CRDs, and high CVH protects against all-cause and CLRDs mortality.

慢性呼吸系统疾病（CRDs）是一个全球性的健康挑战。虽然已知个人生活方式因素会影响心血管疾病的风险，但综合心血管健康（CVH）指标的集体作用仍不太清楚。生命基本8 （Life 's Essential 8, LE8）提供了CVH的整体衡量指标，但其与CRDs和相关死亡率的关系在人群水平上尚未得到证实。方法观察性研究基于美国国家健康与营养检查调查（NHANES 2007-2018）。我们调整了混杂因素，并使用调查加权逻辑回归分析来评估LE8与CRDs风险和亚型之间的关系。限制三次样条（RCS）评估非线性关系。并进行了亚组分析和敏感性分析。Cox模型研究了LE8对全因和慢性下呼吸道疾病（clrd）死亡率的影响。结果观察性研究包括30,863名参与者。在调整混杂因素后，调查加权逻辑回归显示LE8与CRDs和四种亚型的风险呈负相关，其中肺气肿的相关性最显著（OR = 0.96, 95% CI: 0.95, 0.97, P < 0.001）。RCS提示LE8与CRDs之间存在非线性关系。亚组分析和敏感性分析证实了结果的稳健性。与低CVH个体相比，高CVH个体的全因死亡率和clrd死亡率风险较低（HR = 0.82, 95% CI: 0.71, 0.93, P = 0.003; HR = 0.27, 95% CI: 0.08, 0.88, P = 0.030）。结论le8与冠心病呈负相关，高CVH可降低全因死亡率和冠心病死亡率。

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引用次数: 0

Recurrent device-related thrombosis after left atrial appendage closure with the watchman FLX: A case report and literature review watchman FLX关闭左心房附件后器械相关性血栓复发1例报告并文献复习

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2026-03-01 Epub Date: 2025-10-14 DOI: 10.1016/j.ijcrp.2025.200527

Yuemiao Jiao, Yue Yu, Guangyuan Song, Chengqian Yin

Background

Left atrial appendage closure (LAAC) effectively lowers stroke risk in atrial-fibrillation (AF) patients who cannot tolerate long-term anticoagulation. Device-related thrombosis (DRT), although infrequent, carries a threefold increase in subsequent embolic events and remains a therapeutic challenge, even with the newer Watchman FLX occluder.

Case summary

A 72-year-old woman with paroxysmal AF (CHA₂DS₂-VASc = 5; HAS-BLED = 2) underwent LAAC with a 30 mm Watchman FLX after bleeding-limited warfarin use. She was prescribed dual antiplatelet therapy (DAPT) post-procedure. Eight weeks later, cardiac CT detected a device-surface thrombus; warfarin (INR 2.5–3.0) achieved complete resolution by 7 months. Despite continued anticoagulation, repeat CT at 22 months revealed a larger thrombus. Transesophageal echocardiography confirmed recurrent DRT.

Discussion

This case underscores multifactorial DRT pathogenesis: patient-specific hypercoagulability (age, persistent AF, PAI-1 variant), anatomic factors (large LAA, 30 mm device), and premature INR reduction. Current evidence indicates that early hypoattenuation thickening on cardiac CT, peri-device leak, and suboptimal antithrombotic regimens are associated with DRT. Emerging data support CT-based surveillance, individualized anticoagulation—potentially favoring direct oral anticoagulants (DOACs)—and next-generation, endothelialization-oriented device designs.

Conclusion

Recurrent, large-burden DRT can occur late after Watchman FLX implantation despite initial thrombus resolution and guideline-directed therapy. Optimal management requires (1) vigilant, multimodality imaging follow-up; (2) stringent, patient-tailored anticoagulation with real-time INR or DOAC level assessment; (3) consideration of genetic or laboratory markers of thrombophilia; and (4) advances in device bioengineering to accelerate endothelial healing. Further studies should refine risk-stratified antithrombotic strategies and validate imaging biomarkers to pre-empt DRT in high-risk LAAC recipients.

背景：左心房附件关闭术（LAAC）可有效降低不能耐受长期抗凝治疗的房颤（AF）患者的卒中风险。器械相关血栓形成（DRT）虽然不常见，但随后的栓塞事件增加了三倍，即使使用较新的Watchman FLX闭塞器，仍然是一个治疗挑战。病例总结：一名72岁的阵发性房颤女性（CHA2DS2-VASc = 5; HAS-BLED = 2）在使用限出血华法林后用30mm Watchman FLX行LAAC。术后给予双重抗血小板治疗（DAPT）。8周后，心脏CT检测到装置表面血栓；华法林（INR 2.5-3.0）在7个月时达到完全缓解。尽管持续抗凝，22个月时复查CT显示血栓变大。经食管超声心动图证实复发性DRT。本病例强调了多因素DRT发病机制：患者特异性高凝性（年龄、持续性房颤、PAI-1变异）、解剖因素（大LAA、30 mm装置）和过早INR降低。目前的证据表明，心脏CT上的早期低衰减增厚、装置周围泄漏和次优抗血栓治疗方案与DRT有关。新出现的数据支持基于ct的监测、个体化抗凝（可能倾向于直接口服抗凝剂（DOACs））和下一代内皮化导向的设备设计。结论Watchman FLX植入后，尽管最初的血栓消退和指导治疗，复发性大负荷DRT仍可能发生在晚期。优化管理需要(1)警惕、多模式的影像学随访；(2)严格的、针对患者的抗凝治疗，实时评估INR或DOAC水平；(3)考虑血栓形成的遗传或实验室标记；(4)加速内皮细胞愈合的装置生物工程进展。进一步的研究应该完善风险分层的抗血栓策略，并验证成像生物标志物，以预防高危LAAC受体的DRT。

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引用次数: 0

Relationship between nutrition status and muscle mass and its impact on 1-year mortality in patients with aortic stenosis undergoing transcatheter aortic valve implantation 经导管主动脉瓣置入术主动脉瓣狭窄患者营养状况与肌肉质量的关系及其对1年死亡率的影响

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2026-03-01 Epub Date: 2026-01-07 DOI: 10.1016/j.ijcrp.2026.200573

Hiroyo Miyata , Koichiro Matsumura , Kazue Hamamura , Masakazu Yasuda , Shohei Hakozaki , Kyohei Onishi , Eijiro Yagi , Kosuke Fujita , Katsumi Kajihara , Teruyoshi Amagai , Masafumi Ueno , Gaku Nakazawa

Background

We aimed to evaluate whether dual assessment of nutritional status and muscle mass could enhance the prediction of 1-year mortality in patients undergoing transcatheter aortic valve implantation (TAVI).

Methods

This retrospective study included 312 consecutive patients who underwent TAVI for aortic stenosis. Nutritional status was determined by calculating the geriatric nutritional risk index (GNRI), with a cutoff of 98. Muscle mass was calculated from the psoas muscle volume index (PMVI). Patients were stratified into three groups based on GNRI and PMVI: Low, middle, and high groups (GNRI: < 98, < 98, and > 98; and below, or below, and above the sex-specific median PMVI, respectively). The primary endpoint was all-cause mortality within 1-year.

Results

After exclusion, 259 patients were included in the analysis, and 22 died within 1-year. Kaplan-Meier survival curves showed a significant difference in all-cause mortality within 1-year among the three groups. Multivariate analysis of the Cox proportional hazards model for factors related to all-cause mortality within 1-year showed no significant association in the middle group when the high group was used as a reference, and the low group was independently associated.

Conclusion

The combined assessment of nutritional status and muscle mass improves the identification of high-risk patients undergoing transcatheter aortic valve implantation and enhances the prognostic accuracy beyond individual markers. This approach may aid in refining the risk stratification and tailoring the perioperative management of patients undergoing TAVI.

背景：我们旨在评估营养状况和肌肉质量的双重评估是否可以增强对经导管主动脉瓣植入术（TAVI）患者1年死亡率的预测。方法本回顾性研究纳入312例连续接受TAVI治疗主动脉瓣狭窄的患者。通过计算老年人营养风险指数（GNRI）来确定营养状况，截止值为98。肌肉质量由腰肌体积指数（PMVI）计算。根据GNRI和PMVI将患者分为三组：低、中、高组（GNRI分别为<； 98、< 98、>； 98及低于或低于、高于性别特异性中位PMVI）。主要终点是1年内的全因死亡率。结果经排除后，259例患者纳入分析，其中22例在1年内死亡。Kaplan-Meier生存曲线显示三组1年内全因死亡率有显著差异。Cox比例风险模型对1年内全因死亡率相关因素的多因素分析显示，以高组为参照，中组无显著相关性，低组独立相关。结论营养状况和肌肉质量的联合评估提高了对经导管主动脉瓣置入术高危患者的识别，提高了预后的准确性。这种方法可能有助于完善风险分层和定制TAVI患者的围手术期管理。

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引用次数: 0

Housing distance, salt intake and cardiovascular risk in rural Aceh Tamiang: Insights utilizing the WHO 10-year non-laboratory assessment 居住距离、盐摄入量和亚齐Tamiang农村心血管风险：利用世卫组织10年非实验室评估的见解

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2026-03-01 Epub Date: 2025-12-21 DOI: 10.1016/j.ijcrp.2025.200560

Nadya Keumala Fitri , Bahagia Willibrordus Maria Nainggolan , Yusrina Br Saragih , Dina Keumala Sari

Background

Assessing cardiovascular disease (CVD) risk is a major challenge in rural areas due to limited access and resources. Addressing this issue is crucial for developing effective public health interventions.

Methods

This cross-sectional study utilized the World Health Organization (WHO) 10-year cardiovascular risk assessment charts. Variables included housing distance to the nearest community health center (CHC), salt consumption, and physical activity. Data were analyzed using logistic regression.

Findings

Among 1000 participants, 24.6 % were classified as high-risk. Significant predictors included salt consumption (odds ratio [OR] = 3.87, 95 % CI: 2.46–6.06) and distance to the CHC (OR = 2.2, 95 % CI: 1.44–3.35). The predicted probability of high CVD risk is related to with both housing distance (Estimate = 0.098, SE = 0.018, z = 5.45, p < 0.001) and salt consumption (Estimate = 1.524, SE = 0.158, z = 9.63, p < 0.001).

Conclusion

This study highlights the significance of modifiable factors, specifically higher salt consumption and greater distance to a CHC, on CVD risk in a rural Indonesian population.

由于获取途径和资源有限，评估心血管疾病（CVD）风险在农村地区是一项重大挑战。解决这一问题对于制定有效的公共卫生干预措施至关重要。方法本研究采用世界卫生组织（WHO） 10年心血管风险评估图。变量包括到最近的社区卫生中心（CHC）的住房距离、盐摄入量和身体活动。数据采用逻辑回归分析。在1000名参与者中，24.6%的人被列为高危人群。显著预测因子包括盐摄入量（比值比[OR] = 3.87, 95% CI: 2.46-6.06）和与CHC的距离（OR = 2.2, 95% CI: 1.44-3.35）。预测的心血管疾病高风险概率与居住距离（估计值= 0.098,SE = 0.018, z = 5.45, p < 0.001）和食盐摄入量（估计值= 1.524,SE = 0.158, z = 9.63, p < 0.001）有关。结论：本研究强调了印尼农村人群心血管疾病风险的可改变因素的重要性，特别是较高的盐摄入量和距离CHC较远。

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引用次数: 0

Global burden of non-rheumatic calcific aortic valve disease in adults aged 60 years and older, with projections to 2041: insights from the Global Burden of Disease Study 2021 60岁及以上成人非风湿性钙化主动脉瓣疾病的全球负担，预测到2041年：来自2021年全球疾病负担研究的见解

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2026-03-01 Epub Date: 2025-12-18 DOI: 10.1016/j.ijcrp.2025.200565

Jie Tan , Xiaoqing Fu , Xiaoqi Li , Xiaorui Zhao , Wenqi Huang , Jing Huang , Li Xu

Background

This study aimed to explore the most recent trends in NRCAVD burden among adults aged 60 years and older and to further predict trends up to 2041.

Methods

We estimated the age-standardized incidence (ASIR), prevalence (ASPR), disability-adjusted life years (DALYs) (ASDALYsR) and death rates (ASDR) of NRCAVD in adults aged ≥60 years from 1990 to 2021 using data from the 2021 Global Burden of Disease Study. Temporal trends were quantified using average annual percent change and projections to 2041 were made using the Nordpred model.

Results

Globally, in 2021, NRCAVD affected 11.78 million older adults (ASPR: 1122.7/100,000), with 0.84 million new cases (ASIR: 77.3/100,000), resulting in 132,764 deaths (ASDR: 13.7/100,000) and an ASDALYsR of 182 per 100,000. From 1990 to 2021, global ASIR and ASPR increased significantly (22.1 % and 24.8 %, respectively), while ASDALYsR and ASDR declined. High-income regions exhibited the greatest disease burden, notably High-income North America and Western Europe. Marked sex-based differences existed, with males showing higher burden compared to females. Projections indicate that by 2041, the absolute number of cases will rise by 72.1 %.

Conclusions

The global burden of NRCAVD in older adults is substantial and varies by age, gender, socio-demographic index, and region. Despite declining age-standardized rates, the absolute burden of NRCAVD will increase, highlighting the need for early screening and improved treatment access.

本研究旨在探讨60岁及以上成人NRCAVD负担的最新趋势，并进一步预测到2041年的趋势。方法利用2021年全球疾病负担研究的数据，估计1990年至2021年年龄≥60岁成人NRCAVD的年龄标准化发病率（ASIR）、患病率（ASPR）、残疾调整生命年（DALYs）（ASDALYsR）和死亡率（ASDR）。使用年均百分比变化量化了时间趋势，并使用Nordpred模式进行了到2041年的预估。结果在全球范围内，2021年NRCAVD影响了1178万老年人（ASPR: 1122.7/10万），新发病例84万（ASIR: 77.3/10万），导致132764例死亡（ASDR: 13.7/10万），ASDALYsR为182 /10万。从1990年到2021年，全球ASIR和ASPR显著上升（分别为22.1%和24.8%），而ASDALYsR和ASDR下降。高收入地区表现出最大的疾病负担，特别是高收入的北美和西欧。存在明显的性别差异，男性的负担高于女性。预测表明，到2041年，病例的绝对数量将增加72.1%。结论全球老年人NRCAVD负担巨大，且因年龄、性别、社会人口指数和地区而异。尽管年龄标准化率下降，但NRCAVD的绝对负担将增加，这突出了早期筛查和改善治疗机会的必要性。

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引用次数: 0

Prognostic value of the left atrioventricular coupling index for adverse cardiac outcomes in hypertrophic cardiomyopathy 肥厚性心肌病患者左房室耦合指数对不良心脏预后的预测价值

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2026-03-01 Epub Date: 2025-12-24 DOI: 10.1016/j.ijcrp.2025.200566

Sittinop Titichoatrattana , Ing-orn Arunakul , Paisit Kosum , Aree Maitaothong , Em-on Puripun , Monravee Tumkosit , Yongkasem Vorasettakarnkij , Pairoj Chattranukulchai , Nonthikorn Theerasuwipakorn

Background

Hypertrophic cardiomyopathy (HCM) involves left atrial remodeling linked to adverse outcomes such as death, heart failure, and atrial fibrillation (AF). The left atrioventricular coupling index (LACI) reflects atrial–ventricular interaction, but its prognostic role in HCM is unclear. The objective of this study is to evaluate the prognostic value of cardiac magnetic resonance imaging (CMR)-derived LACI and identify optimal cut-offs for predicting adverse outcomes in HCM.

Methods

This retrospective cohort study included HCM patients who underwent CMR with at least 1 year of follow-up. LACI was calculated as the ratio of left atrial to left ventricular end-diastolic volume. Associations between LACI and outcomes were analyzed using Cox regression. The primary outcome was a composite endpoint of all-cause death and hospitalization for heart failure (HHF). Secondary outcomes included all-cause death, HHF, and new-onset AF. Receiver operating characteristic (ROC) analysis determined optimal LACI cut-offs.

Results

Among 183 patients (median age 61 years; 59 % male) followed for 4.2 years, 53 (29 %) reached the primary endpoint. Elevated LACI independently predicted the primary composite endpoint (≥0.41: aHR 2.24, 95 %CI: 1.19, 4.24, p = 0.013), HHF (≥0.44: aHR 4.54, 95 %CI: 1.69, 12.19, p = 0.003), and new-onset AF (≥0.44: aHR 3.06, 95 %CI: 1.26, 7.43, p = 0.003) but not all-cause death.

Conclusion

CMR-derived LACI independently predicted adverse outcomes in HCM, offering a reproducible marker for improved risk stratification.

肥厚性心肌病（HCM）涉及左心房重构，与死亡、心力衰竭和心房颤动（AF）等不良结局相关。左房室耦合指数（LACI）反映房室相互作用，但其在HCM中的预后作用尚不清楚。本研究的目的是评估心脏磁共振成像（CMR）衍生的LACI的预后价值，并确定预测HCM不良结局的最佳截止值。方法本回顾性队列研究纳入了接受CMR治疗的HCM患者，随访至少1年。LACI计算为左房容积与左室舒张末期容积之比。采用Cox回归分析LACI与预后之间的关系。主要终点是全因死亡和心力衰竭住院（HHF）的复合终点。次要结局包括全因死亡、HHF和新发房颤。受试者工作特征（ROC）分析确定了最佳LACI截止值。结果183例患者（中位年龄61岁，59%为男性）随访4.2年，53例（29%）达到主要终点。升高的LACI独立预测主要复合终点（≥0.41:aHR 2.24, 95% CI: 1.19, 4.24, p = 0.013）、HHF（≥0.44:aHR 4.54, 95% CI: 1.69, 12.19, p = 0.003）和新发AF(≥0.44:aHR 3.06, 95% CI: 1.26, 7.43, p = 0.003)，但不能预测全因死亡。结论cmr衍生的LACI可独立预测HCM的不良结局，为改善风险分层提供了可重复的标记。

{"title":"Prognostic value of the left atrioventricular coupling index for adverse cardiac outcomes in hypertrophic cardiomyopathy","authors":"Sittinop Titichoatrattana , Ing-orn Arunakul , Paisit Kosum , Aree Maitaothong , Em-on Puripun , Monravee Tumkosit , Yongkasem Vorasettakarnkij , Pairoj Chattranukulchai , Nonthikorn Theerasuwipakorn","doi":"10.1016/j.ijcrp.2025.200566","DOIUrl":"10.1016/j.ijcrp.2025.200566","url":null,"abstract":"<div><h3>Background</h3><div>Hypertrophic cardiomyopathy (HCM) involves left atrial remodeling linked to adverse outcomes such as death, heart failure, and atrial fibrillation (AF). The left atrioventricular coupling index (LACI) reflects atrial–ventricular interaction, but its prognostic role in HCM is unclear. The objective of this study is to evaluate the prognostic value of cardiac magnetic resonance imaging (CMR)-derived LACI and identify optimal cut-offs for predicting adverse outcomes in HCM.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included HCM patients who underwent CMR with at least 1 year of follow-up. LACI was calculated as the ratio of left atrial to left ventricular end-diastolic volume. Associations between LACI and outcomes were analyzed using Cox regression. The primary outcome was a composite endpoint of all-cause death and hospitalization for heart failure (HHF). Secondary outcomes included all-cause death, HHF, and new-onset AF. Receiver operating characteristic (ROC) analysis determined optimal LACI cut-offs.</div></div><div><h3>Results</h3><div>Among 183 patients (median age 61 years; 59 % male) followed for 4.2 years, 53 (29 %) reached the primary endpoint. Elevated LACI independently predicted the primary composite endpoint (≥0.41: aHR 2.24, 95 %CI: 1.19, 4.24, p = 0.013), HHF (≥0.44: aHR 4.54, 95 %CI: 1.69, 12.19, p = 0.003), and new-onset AF (≥0.44: aHR 3.06, 95 %CI: 1.26, 7.43, p = 0.003) but not all-cause death.</div></div><div><h3>Conclusion</h3><div>CMR-derived LACI independently predicted adverse outcomes in HCM, offering a reproducible marker for improved risk stratification.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"28 ","pages":"Article 200566"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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