International Journal of Cardiology Cardiovascular Risk and Prevention最新文献_第6页

Correspondence: Risk assessment and prevention of cardiovascular events in patients with obstructive sleep apnea syndrome: A narrative review 通讯：阻塞性睡眠呼吸暂停综合征患者心血管事件的风险评估和预防：一项叙述性综述

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2025-12-01 Epub Date: 2025-07-11 DOI: 10.1016/j.ijcrp.2025.200470

Muhammad Ismail , Shad Khan , Sadaqat Ullah Rehmat , Farman Ullah Khan

引用次数: 0

Electrocardiogram markers predicting ischemic stroke after acute coronary syndrome 心电图指标预测急性冠状动脉综合征后缺血性卒中

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2025-12-01 Epub Date: 2025-08-22 DOI: 10.1016/j.ijcrp.2025.200500

Matilda Hurskainen , Juho Tynkkynen , Leo-Pekka Lyytikäinen , Terho Lehtimäki , Kjell Nikus , Jussi Hernesniemi

Background

Patients with coronary artery disease (CAD) have increased risk of ischemic stroke (IS). Our aim was to screen for significant electrocardiogram (ECG) features for IS risk in patients treated for acute coronary syndrome (ACS).

Methods

This retrospective registry study is based on 7760 ACS patients treated in Tays Heart Hospital (2007–2018) with follow-up for incident IS until December 31st^, 2020. ECGs recorded during ACSs were analysed by the Marquette™ 12SL™ ECG Analysis Program version 24. Preliminary screening for ECG features was conducted using age- and sex adjusted Cox regression analysis and corrected by multiple testing (Bonferroni method). Highly correlated variables were excluded from the final age-, sex- and atrial fibrillation (AF)/atrial flutter (AFL) adjusted Cox regression and subdistribution hazard (SDH) multivariable analyses.

Results

From 7760 patients, 489 (6.3 %) suffered IS during a median follow-up of 5.7 years (IQR 3.1–8.8). In the final multivariable model, the main risk factors were premature ventricular complexes (PVCs) or aberrantly conducted complexes in AF/AFL (SDH, 2.01 [1.22–3.31]), left ventricular (LV) hypertrophy (LVH) by Sokolow-Lyon criteria (SDH, 1.52 [1.12–2.06]), S wave amplitude in lead V4 (SDH, 1.13 [1.05–1.21]) and negative P wave peak time in lead V2 (SDH, 1.12 [1.02–1.23]). T wave amplitude in lead V6 (SDH, 0.78 [0.69–0.88]) and T wave duration in lead aVL (SDH, 0.85 [0.78–0.92]) showed an inverse association with IS risk. The continuous variables correspond to 1 SD.

Conclusions

ECG markers demonstrating LV dysfunction, LVH and atriopathy associate with IS risk after ACS, although external validation is still required.

背景：冠心病（CAD）患者发生缺血性卒中（IS）的风险增加。我们的目的是筛查急性冠脉综合征（ACS）患者的重要心电图（ECG）特征。方法本回顾性登记研究基于2007-2018年在Tays心脏医院接受治疗的7760例ACS患者，随访至2020年12月31日。通过Marquette™12SL™ECG分析程序版本24分析ACSs期间记录的心电图。采用年龄和性别校正的Cox回归分析对心电图特征进行初步筛选，并通过多重检验（Bonferroni法）进行校正。高度相关的变量被排除在最终年龄、性别和心房颤动(AF)/心房扑动（AFL）校正Cox回归和亚分布风险（SDH）多变量分析之外。结果在中位随访5.7年（IQR 3.1-8.8）期间，7760例患者中，489例（6.3%）患有IS。在最终的多变量模型中，主要危险因素为房内/房内l室性早搏复合物（PVCs）或传导异常复合物（SDH, 2.01[1.22-3.31]）、Sokolow-Lyon标准左室（LV）肥厚（LVH）（SDH, 1.52[1.12 - 2.06]）、V4导联S波振幅（SDH, 1.13[1.05-1.21]）和V2导联P波峰值时间（SDH, 1.12[1.02-1.23]）。V6导联T波振幅（SDH, 0.78[0.69-0.88]）和aVL导联T波持续时间（SDH, 0.85[0.78 - 0.92]）与IS风险呈负相关。连续变量对应1个SD。结论secg标记显示左室功能障碍、左室h和心房病变与ACS后IS风险相关，但仍需要外部验证。

{"title":"Electrocardiogram markers predicting ischemic stroke after acute coronary syndrome","authors":"Matilda Hurskainen , Juho Tynkkynen , Leo-Pekka Lyytikäinen , Terho Lehtimäki , Kjell Nikus , Jussi Hernesniemi","doi":"10.1016/j.ijcrp.2025.200500","DOIUrl":"10.1016/j.ijcrp.2025.200500","url":null,"abstract":"<div><h3>Background</h3><div>Patients with coronary artery disease (CAD) have increased risk of ischemic stroke (IS). Our aim was to screen for significant electrocardiogram (ECG) features for IS risk in patients treated for acute coronary syndrome (ACS).</div></div><div><h3>Methods</h3><div>This retrospective registry study is based on 7760 ACS patients treated in Tays Heart Hospital (2007–2018) with follow-up for incident IS until December 31st<sup>,</sup> 2020. ECGs recorded during ACSs were analysed by the Marquette™ 12SL™ ECG Analysis Program version 24. Preliminary screening for ECG features was conducted using age- and sex adjusted Cox regression analysis and corrected by multiple testing (Bonferroni method). Highly correlated variables were excluded from the final age-, sex- and atrial fibrillation (AF)/atrial flutter (AFL) adjusted Cox regression and subdistribution hazard (SDH) multivariable analyses.</div></div><div><h3>Results</h3><div>From 7760 patients, 489 (6.3 %) suffered IS during a median follow-up of 5.7 years (IQR 3.1–8.8). In the final multivariable model, the main risk factors were premature ventricular complexes (PVCs) or aberrantly conducted complexes in AF/AFL (SDH, 2.01 [1.22–3.31]), left ventricular (LV) hypertrophy (LVH) by Sokolow-Lyon criteria (SDH, 1.52 [1.12–2.06]), S wave amplitude in lead V4 (SDH, 1.13 [1.05–1.21]) and negative P wave peak time in lead V2 (SDH, 1.12 [1.02–1.23]). T wave amplitude in lead V6 (SDH, 0.78 [0.69–0.88]) and T wave duration in lead aVL (SDH, 0.85 [0.78–0.92]) showed an inverse association with IS risk. The continuous variables correspond to 1 SD.</div></div><div><h3>Conclusions</h3><div>ECG markers demonstrating LV dysfunction, LVH and atriopathy associate with IS risk after ACS, although external validation is still required.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"27 ","pages":"Article 200500"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913540","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}

引用次数: 0

Mental health status and cardiovascular outcomes across Life's Essential 8 categories 心理健康状况和心血管疾病在生活中必不可少的8个类别

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2025-12-01 Epub Date: 2025-11-14 DOI: 10.1016/j.ijcrp.2025.200545

Enze Li , Le Zhou , Liu He, Song Zuo, Song-Nan Li, Xiao-Xia Liu, Cai-Hua Sang, Jian-Zeng Dong, Xue-Yuan Guo, Changsheng Ma

Background

Anxiety and depression are established risk factors for cardiovascular disease (CVD); impacts of these conditions on cardiovascular outcomes across different levels of cardiovascular health (CVH), measured by Life's Essential 8 (LE8) scores, remain unclear.

Methods and results

We analyzed 290,778 UK Biobank participants (mean age 56.5, 56.1 % male) without prior CVD. CVH was assessed using the LE8 score. Mental health status (healthy, anxiety only, depression only, or comorbid anxiety and depression) was determined through PHQ-4 items and ICD-10 codes (F32-F33 for depression, F40-F41 for anxiety). Cardiovascular outcomes were defined as a composite of coronary heart disease (CHD), heart failure (HF), and stroke. Cox proportional hazards models were adjusted for confounders and stratified by LE8 score (<50 [poor CVH] vs. ≥50 [intermediate-optimal]). Compared to the mentally healthy group, participants with comorbid anxiety and depression had the highest overall cardiovascular risk (adjusted HR 1.85 [95 % CI 1.74–1.97]). The impact of mental health status varied according to baseline LE8 scores. Among those with LE8 <50, isolated anxiety (adjusted HR 1.23 [1.09–1.40]), depression (adjusted HR 1.34 [1.22–1.47]), as well as comorbid anxiety and depression (adjusted HR 1.46 [1.31–1.64]) were all associated with increased cardiovascular risk. In the LE8 ≥50 group, isolated anxiety (adjusted HR 1.39 [1.30–1.48]), isolated depression (adjusted HR 1.52 [1.43–1.60]), and comorbid anxiety and depression (adjusted HR 1.78 [1.66–1.90]) were all associated with increased risk.

Conclusions

Mental health independently affects cardiovascular risk, modified by baseline CVH. Mental health emerge as a relative risk predictor among individuals with CVH (LE8 ≥ 50).

背景焦虑和抑郁是心血管疾病（CVD）的危险因素；这些条件对不同心血管健康水平（CVH）的心血管结果的影响（以生命基本8 （LE8）评分衡量）仍不清楚。方法和结果我们分析了290,778名UK Biobank参与者（平均年龄56.5岁，56.1%为男性）既往无心血管疾病。CVH采用LE8评分进行评估。通过PHQ-4项目和ICD-10代码（抑郁为F32-F33，焦虑为F40-F41）确定心理健康状况（健康、仅焦虑、仅抑郁或共患焦虑和抑郁）。心血管结局被定义为冠心病（CHD）、心力衰竭（HF）和中风的综合结果。对Cox比例风险模型进行混杂因素调整，并按LE8评分分层（<；50[差CVH] vs.≥50[中优]）。与心理健康组相比，患有焦虑和抑郁共病的参与者总体心血管风险最高（调整后HR 1.85 [95% CI 1.74-1.97]）。心理健康状况的影响因基线LE8得分而异。在LE8 <；50的患者中，孤立性焦虑（调整后的HR为1.23[1.09-1.40]）、抑郁（调整后的HR为1.34[1.22-1.47]）以及共病性焦虑和抑郁（调整后的HR为1.46[1.31-1.64]）均与心血管风险增加相关。在LE8≥50组中，孤立性焦虑（调整后的HR为1.39[1.30-1.48]）、孤立性抑郁（调整后的HR为1.52[1.43-1.60]）、焦虑和抑郁共病（调整后的HR为1.78[1.66-1.90]）均与风险增加相关。结论心理健康独立影响心血管风险，并受基线CVH影响。精神健康是CVH患者（LE8≥50）的相对风险预测因子。

{"title":"Mental health status and cardiovascular outcomes across Life's Essential 8 categories","authors":"Enze Li , Le Zhou , Liu He, Song Zuo, Song-Nan Li, Xiao-Xia Liu, Cai-Hua Sang, Jian-Zeng Dong, Xue-Yuan Guo, Changsheng Ma","doi":"10.1016/j.ijcrp.2025.200545","DOIUrl":"10.1016/j.ijcrp.2025.200545","url":null,"abstract":"<div><h3>Background</h3><div>Anxiety and depression are established risk factors for cardiovascular disease (CVD); impacts of these conditions on cardiovascular outcomes across different levels of cardiovascular health (CVH), measured by Life's Essential 8 (LE8) scores, remain unclear.</div></div><div><h3>Methods and results</h3><div>We analyzed 290,778 UK Biobank participants (mean age 56.5, 56.1 % male) without prior CVD. CVH was assessed using the LE8 score. Mental health status (healthy, anxiety only, depression only, or comorbid anxiety and depression) was determined through PHQ-4 items and ICD-10 codes (F32-F33 for depression, F40-F41 for anxiety). Cardiovascular outcomes were defined as a composite of coronary heart disease (CHD), heart failure (HF), and stroke. Cox proportional hazards models were adjusted for confounders and stratified by LE8 score (<50 [poor CVH] vs. ≥50 [intermediate-optimal]). Compared to the mentally healthy group, participants with comorbid anxiety and depression had the highest overall cardiovascular risk (adjusted HR 1.85 [95 % CI 1.74–1.97]). The impact of mental health status varied according to baseline LE8 scores. Among those with LE8 <50, isolated anxiety (adjusted HR 1.23 [1.09–1.40]), depression (adjusted HR 1.34 [1.22–1.47]), as well as comorbid anxiety and depression (adjusted HR 1.46 [1.31–1.64]) were all associated with increased cardiovascular risk. In the LE8 ≥50 group, isolated anxiety (adjusted HR 1.39 [1.30–1.48]), isolated depression (adjusted HR 1.52 [1.43–1.60]), and comorbid anxiety and depression (adjusted HR 1.78 [1.66–1.90]) were all associated with increased risk.</div></div><div><h3>Conclusions</h3><div>Mental health independently affects cardiovascular risk, modified by baseline CVH. Mental health emerge as a relative risk predictor among individuals with CVH (LE8 ≥ 50).</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"27 ","pages":"Article 200545"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576232","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}

引用次数: 0

Vitamin D insufficiency and cardiovascular involvement in systemic sclerosis: Association with echocardiographic parameters and risk factors 系统性硬化症中维生素D不足和心血管累及：与超声心动图参数和危险因素的关系

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2025-12-01 Epub Date: 2025-08-26 DOI: 10.1016/j.ijcrp.2025.200502

Gianluca Pagnoni , Dilia Giuggioli , Marco de Pinto , Arianna Maini , Elisa Battigaglia , Pierluca Macripò , Amelia Spinella , Giulia Olivetti , Antonio Manenti , Marcello Pinti , Giuseppe Boriani , Daniela Aschieri , Anna Vittoria Mattioli , Francesco Fedele , Francesca Coppi

Background

Vitamin D plays several roles beyond bone metabolism, potentially protecting the cardiovascular system. Systemic sclerosis (SSc) is an autoimmune disease characterized by fibrosis and vascular dysfunction, carrying a high cardiovascular risk. However, the relationship between vitamin D insufficiency and cardiovascular involvement in SSc patients remains unclear. This study aims to assess the association between low vitamin D levels, echocardiographic parameters indicative of ventricular dysfunction, and cardiovascular risk factors in SSc patients.

Methods

A retrospective observational study involved 160 SSc patients undergoing echocardiography and serum 25-hydroxyvitamin D measurement. Patients were categorized into two groups: vitamin D insufficiency (<30 ng/mL) and normal levels (≥30 ng/mL). Echocardiographic parameters and cardiovascular risk factors were evaluated.

Results

Vitamin D insufficiency was detected in 68.9 % of patients. Patients with insufficient vitamin D had higher systolic pulmonary arterial pressure (PAPs; 37.68 ± 7.56 mmHg vs. 33.12 ± 6.17 mmHg; p = 0.004), reduced TAPSE/PAPs ratio (0.65 ± 0.13 vs. 0.72 ± 0.14; p = 0.021), increased interventricular septal thickness (8.17 ± 1.28 mm vs. 7.69 ± 1.18 mm; p = 0.028), and greater left ventricular end-diastolic diameter (44.06 ± 4.28 mm vs. 42.67 ± 3.44 mm; p = 0.037), indicating ventricular dysfunction. Vitamin D insufficiency significantly correlated with hypertension (OR = 2.31; p = 0.032), dyslipidemia (OR = 2.45; p = 0.015), and overweight/obesity (OR = 4.73; p = 0.002), but not with diabetes or smoking.

Conclusions

Vitamin D insufficiency may contribute to cardiovascular dysfunction in SSc patients. Monitoring vitamin D levels might improve cardiovascular risk stratification. Further studies are necessary to determine if supplementation could enhance cardiac outcomes.

除了骨骼代谢，维生素D还具有多种作用，可能保护心血管系统。系统性硬化症（SSc）是一种以纤维化和血管功能障碍为特征的自身免疫性疾病，具有较高的心血管风险。然而，SSc患者维生素D不足与心血管疾病之间的关系尚不清楚。本研究旨在评估SSc患者低维生素D水平、指示心室功能障碍的超声心动图参数和心血管危险因素之间的关系。方法对160例SSc患者进行超声心动图和血清25-羟基维生素D测定。患者分为两组：维生素D不足（≤30 ng/mL）和正常（≥30 ng/mL）。评价超声心动图参数及心血管危险因素。结果68.9%的患者存在维生素D不足。维生素D不足患者肺动脉收缩压升高（PAPs; 37.68±7.56 mmHg vs. 33.12±6.17 mmHg; p = 0.004）， TAPSE/PAPs比值降低（0.65±0.13 vs. 0.72±0.14;p = 0.021），室间隔厚度增加（8.17±1.28 mm vs. 7.69±1.18 mm; p = 0.028），左室舒张末期内径增大（44.06±4.28 mm vs. 42.67±3.44 mm; p = 0.037），提示心室功能障碍。维生素D不足与高血压（OR = 2.31; p = 0.032）、血脂异常（OR = 2.45; p = 0.015）和超重/肥胖（OR = 4.73; p = 0.002）显著相关，但与糖尿病或吸烟无关。结论维生素D不足可能导致SSc患者心血管功能障碍。监测维生素D水平可能改善心血管风险分层。需要进一步的研究来确定补充剂是否可以改善心脏预后。

{"title":"Vitamin D insufficiency and cardiovascular involvement in systemic sclerosis: Association with echocardiographic parameters and risk factors","authors":"Gianluca Pagnoni , Dilia Giuggioli , Marco de Pinto , Arianna Maini , Elisa Battigaglia , Pierluca Macripò , Amelia Spinella , Giulia Olivetti , Antonio Manenti , Marcello Pinti , Giuseppe Boriani , Daniela Aschieri , Anna Vittoria Mattioli , Francesco Fedele , Francesca Coppi","doi":"10.1016/j.ijcrp.2025.200502","DOIUrl":"10.1016/j.ijcrp.2025.200502","url":null,"abstract":"<div><h3>Background</h3><div>Vitamin D plays several roles beyond bone metabolism, potentially protecting the cardiovascular system. Systemic sclerosis (SSc) is an autoimmune disease characterized by fibrosis and vascular dysfunction, carrying a high cardiovascular risk. However, the relationship between vitamin D insufficiency and cardiovascular involvement in SSc patients remains unclear. This study aims to assess the association between low vitamin D levels, echocardiographic parameters indicative of ventricular dysfunction, and cardiovascular risk factors in SSc patients.</div></div><div><h3>Methods</h3><div>A retrospective observational study involved 160 SSc patients undergoing echocardiography and serum 25-hydroxyvitamin D measurement. Patients were categorized into two groups: vitamin D insufficiency (<30 ng/mL) and normal levels (≥30 ng/mL). Echocardiographic parameters and cardiovascular risk factors were evaluated.</div></div><div><h3>Results</h3><div>Vitamin D insufficiency was detected in 68.9 % of patients. Patients with insufficient vitamin D had higher systolic pulmonary arterial pressure (PAPs; 37.68 ± 7.56 mmHg vs. 33.12 ± 6.17 mmHg; p = 0.004), reduced TAPSE/PAPs ratio (0.65 ± 0.13 vs. 0.72 ± 0.14; p = 0.021), increased interventricular septal thickness (8.17 ± 1.28 mm vs. 7.69 ± 1.18 mm; p = 0.028), and greater left ventricular end-diastolic diameter (44.06 ± 4.28 mm vs. 42.67 ± 3.44 mm; p = 0.037), indicating ventricular dysfunction. Vitamin D insufficiency significantly correlated with hypertension (OR = 2.31; p = 0.032), dyslipidemia (OR = 2.45; p = 0.015), and overweight/obesity (OR = 4.73; p = 0.002), but not with diabetes or smoking.</div></div><div><h3>Conclusions</h3><div>Vitamin D insufficiency may contribute to cardiovascular dysfunction in SSc patients. Monitoring vitamin D levels might improve cardiovascular risk stratification. Further studies are necessary to determine if supplementation could enhance cardiac outcomes.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"27 ","pages":"Article 200502"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932068","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}

引用次数: 0

Healthcare access, symptom burden, and psychological impact in hypertrophic cardiomyopathy: a multinational patient-driven survey 肥厚性心肌病的医疗保健获取、症状负担和心理影响：一项多国患者驱动的调查

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2025-12-01 Epub Date: 2025-08-04 DOI: 10.1016/j.ijcrp.2025.200485

Emil Tsenov , Jolanda Van der Velden , Matteo Pinciroli , Maurizio Pieroni , Franco Cecchi , Iacopo Olivotto , Niccolò Maurizi

Background and aims

Hypertrophic cardiomyopathy (HCM) is a complex genetic heart disease with significant clinical, psychological, and socioeconomic implications. While research has focused on pathophysiology and treatment, patient-reported experiences remain underexplored.

Methods

A cross-sectional, multinational online survey was distributed between December 2024 and February 2025, targeting individuals diagnosed with HCM in Europe. The questionnaire included sections on demographics, symptom burden, impact on daily life, medical management, and psychological well-being. Data were analyzed descriptively, with subgroup analyses based on geography, employment, and healthcare access.

Results

A total of 337 qualifying participants from 18 European countries completed the survey. They were mainly diagnosed because of symptoms (107, 42 %). Specifically, shortness of breath and fatigue had an overall high impact on quality of life, both at diagnosis and at the time of survey (3.09/5 vs 2.93/5; 3.23/5 vs 3.46/5, respectively). With HCM diagnosis, the proportion of patients engaged in low to moderate activities increased significantly (87 % vs 50 %, p < 0.01) and one major psychological complaint was weight gain (71, 49 %). Twenty-two (15 %) patients reported having lost their job because of HCM; 46 (14 %) reported a limitation in working hours as well as limitation in the kind of work performed (32, 9 %), due to the disease. Despite a significant psychological burden access to mental health support was limited, as only 15 % of patients regularly consulted a psychologist.

Conclusions

This survey highlights critical gaps in HCM management, including healthcare accessibility, persistent symptom burden, and unmet psychological needs. Improved care pathways, mental health integration, and workplace accommodations are essential to enhance patient-centered HCM management across Europe.

背景和目的肥厚性心肌病（HCM）是一种复杂的遗传性心脏病，具有重要的临床、心理和社会经济意义。虽然研究主要集中在病理生理学和治疗上，但患者报告的经验仍未得到充分探索。方法在2024年12月至2025年2月期间，对欧洲诊断为HCM的个体进行了一项横断面跨国在线调查。问卷包括人口统计、症状负担、对日常生活的影响、医疗管理和心理健康等部分。对数据进行描述性分析，并根据地理、就业和医疗保健获取情况进行亚组分析。结果共有来自18个欧洲国家的337名合格参与者完成了调查。主要因症状确诊（107.42%）。具体而言，在诊断和调查时，呼吸短促和疲劳对生活质量的总体影响都很高(3.09/5 vs 2.93/5；3.23/5 vs 3.46/5)。HCM诊断后，从事低至中度活动的患者比例显著增加(87% vs 50%, p <；（0.01），主要心理主诉为体重增加（71.49%）。22例（15%）患者报告因HCM而失去工作；46个（14%）报告说，由于这种疾病，工作时间受到限制，工作种类也受到限制（32.9%）。尽管心理负担沉重，但获得心理健康支持的机会有限，因为只有15%的患者定期咨询心理学家。结论本调查突出了HCM管理的关键差距，包括医疗保健可及性、持续症状负担和未满足的心理需求。改善护理途径、心理健康整合和工作场所住宿对于加强整个欧洲以患者为中心的HCM管理至关重要。

{"title":"Healthcare access, symptom burden, and psychological impact in hypertrophic cardiomyopathy: a multinational patient-driven survey","authors":"Emil Tsenov , Jolanda Van der Velden , Matteo Pinciroli , Maurizio Pieroni , Franco Cecchi , Iacopo Olivotto , Niccolò Maurizi","doi":"10.1016/j.ijcrp.2025.200485","DOIUrl":"10.1016/j.ijcrp.2025.200485","url":null,"abstract":"<div><h3>Background and aims</h3><div>Hypertrophic cardiomyopathy (HCM) is a complex genetic heart disease with significant clinical, psychological, and socioeconomic implications. While research has focused on pathophysiology and treatment, patient-reported experiences remain underexplored.</div></div><div><h3>Methods</h3><div>A cross-sectional, multinational online survey was distributed between December 2024 and February 2025, targeting individuals diagnosed with HCM in Europe. The questionnaire included sections on demographics, symptom burden, impact on daily life, medical management, and psychological well-being. Data were analyzed descriptively, with subgroup analyses based on geography, employment, and healthcare access.</div></div><div><h3>Results</h3><div>A total of 337 qualifying participants from 18 European countries completed the survey. They were mainly diagnosed because of symptoms (107, 42 %). Specifically, shortness of breath and fatigue had an overall high impact on quality of life, both at diagnosis and at the time of survey (3.09/5 vs 2.93/5; 3.23/5 vs 3.46/5, respectively). With HCM diagnosis, the proportion of patients engaged in low to moderate activities increased significantly (87 % vs 50 %, p < 0.01) and one major psychological complaint was weight gain (71, 49 %). Twenty-two (15 %) patients reported having lost their job because of HCM; 46 (14 %) reported a limitation in working hours as well as limitation in the kind of work performed (32, 9 %), due to the disease. Despite a significant psychological burden access to mental health support was limited, as only 15 % of patients regularly consulted a psychologist.</div></div><div><h3>Conclusions</h3><div>This survey highlights critical gaps in HCM management, including healthcare accessibility, persistent symptom burden, and unmet psychological needs. Improved care pathways, mental health integration, and workplace accommodations are essential to enhance patient-centered HCM management across Europe.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"27 ","pages":"Article 200485"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144767010","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}

引用次数: 0

Noninvasive coronary imaging: Technological breakthroughs and the integrated application of coronary magnetic resonance angiography 无创冠状动脉成像：冠状动脉磁共振血管成像技术突破及综合应用

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2025-12-01 Epub Date: 2025-11-07 DOI: 10.1016/j.ijcrp.2025.200542

Yiming Sang, Shuang Li, Hui Wang, Hongkai Zhang, Baiyan Zhuang, Lei Xu

With the growing demand for coronary artery visualization and the diagnosis of coronary artery disease, noninvasive coronary imaging modalities have gained significance. Coronary magnetic resonance angiography (CMRA) is a promising technique as it is noninvasive and does not involve ionizing radiation or iodinated contrast agents. Although certain limitations in this technology have prevented its application as a first-line clinical imaging modality, its immense developmental potential has positioned it as a focal point of research. This review discusses the advancements in CMRA across multiple technical domains—including motion correction, imaging acceleration, and integration with artificial intelligence—as well as its current clinical status and future prospects.

随着对冠状动脉可视化和冠状动脉疾病诊断的需求日益增长，无创冠状动脉成像方式具有重要意义。冠状动脉磁共振血管造影（CMRA）是一种很有前途的技术，因为它是无创的，不涉及电离辐射或碘造影剂。尽管该技术的某些限制阻碍了其作为一线临床成像方式的应用，但其巨大的发展潜力使其成为研究的焦点。本文综述了CMRA在多个技术领域的进展，包括运动校正、成像加速和与人工智能的集成，以及目前的临床状况和未来前景。

引用次数: 0

Long-term follow-up study on the impact of a gut microbiota-supportive diet on heart failure and mortality outcomes 肠道菌群支持饮食对心力衰竭和死亡率影响的长期随访研究

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2025-12-01 Epub Date: 2025-10-24 DOI: 10.1016/j.ijcrp.2025.200529

Minghui Xu , Xiaohan Zhang , Haiping xin , Li Daoming , Xuanjian Xiao , Xuecong Zhang , Shilin Tang

Background

Diet-driven modulation of gut microbiota may influence heart failure (HF) risk and mortality, but evidence in large populations is limited. We evaluated the association between a Dietary Index for Gut Microbiota (DI-GM) and prevalent HF.

Methods

DI-GM scores were derived from two 24-h dietary recalls. Logistic regression assessed odds of HF, diabetes, stroke, kidney failure, hypertension, and rheumatoid arthritis across DI-GM categories (1–3, 4, 5, ≥6), adjusting for demographics, lifestyle, BMI, and comorbidities. Restricted cubic splines examined dose–response. Mediation analysis quantified the roles of systemic immune-inflammation index (SII) and C-reactive protein (CRP). Kaplan-Meier and Cox models evaluated all-cause and cardiovascular mortality by DI-GM (>4 vs 1–4).

Results

Compared to DI-GM 1–3, scores of 5 and ≥6 were associated with 21–40 % lower odds of HF (adjusted OR 0.79, p = 0.034; OR 0.60, p = 2.3 × 10⁻⁵). Similar inverse associations were observed for diabetes, stroke, and kidney failure. Spline analysis revealed a nonlinear HF risk decline beyond scores of 4–5. Component-level analyses showed fiber and coffee were linked to significant reductions in CRP, SII and heart failure odds (fiber OR 0.85; coffee OR 0.77). Mediation by SII and CRP accounted for 26 % and 32 % of the DI-GM–HF association. Higher DI-GM (>4) predicted lower all-cause (HR 0.83; p < 0.001) and cardiovascular mortality (HR 0.71; p < 0.001).

Conclusions

Gut-microbiota–supportive diet (DI-GM ≥ 5) is linked to substantially lower prevalence of HF and related conditions, partly via reduced inflammation, and confers long-term survival benefits.

饮食驱动的肠道微生物群调节可能影响心力衰竭（HF）的风险和死亡率，但在大人群中的证据有限。我们评估了肠道微生物群膳食指数（DI-GM）与流行HF之间的关系。方法通过两次24小时饮食回顾得出di - gm评分。Logistic回归评估了在DI-GM分类（1 - 3,4,5,≥6）中HF、糖尿病、中风、肾衰竭、高血压和类风湿性关节炎的发生率，并对人口统计学、生活方式、BMI和合并症进行了调整。限制三次样条检验了剂量-反应。中介分析量化了全身免疫炎症指数（SII）和c反应蛋白（CRP）的作用。Kaplan-Meier和Cox模型通过DI-GM评估全因死亡率和心血管死亡率（>4 vs 1-4）。结果与DI-GM 1-3相比，评分为5分和≥6分的患者发生HF的几率降低21 - 40%（校正OR 0.79, p = 0.034; OR 0.60, p = 2.3 × 10−5）。在糖尿病、中风和肾衰竭中也观察到类似的负相关。样条分析显示，在4-5分以上，HF风险呈非线性下降。成分水平分析显示，纤维和咖啡与显著降低CRP、SII和心力衰竭几率有关（纤维OR为0.85；咖啡OR为0.77）。SII和CRP的介导作用分别占DI-GM-HF相关性的26%和32%。较高的DI-GM （>4）预示较低的全因死亡率（HR 0.83; p < 0.001）和心血管死亡率（HR 0.71; p < 0.001）。结论：支持肠道微生物群的饮食（DI-GM≥5）与心衰及相关疾病的患病率显著降低相关，部分是通过减少炎症，并提供长期生存益处。

{"title":"Long-term follow-up study on the impact of a gut microbiota-supportive diet on heart failure and mortality outcomes","authors":"Minghui Xu , Xiaohan Zhang , Haiping xin , Li Daoming , Xuanjian Xiao , Xuecong Zhang , Shilin Tang","doi":"10.1016/j.ijcrp.2025.200529","DOIUrl":"10.1016/j.ijcrp.2025.200529","url":null,"abstract":"<div><h3>Background</h3><div>Diet-driven modulation of gut microbiota may influence heart failure (HF) risk and mortality, but evidence in large populations is limited. We evaluated the association between a Dietary Index for Gut Microbiota (DI-GM) and prevalent HF.</div></div><div><h3>Methods</h3><div>DI-GM scores were derived from two 24-h dietary recalls. Logistic regression assessed odds of HF, diabetes, stroke, kidney failure, hypertension, and rheumatoid arthritis across DI-GM categories (1–3, 4, 5, ≥6), adjusting for demographics, lifestyle, BMI, and comorbidities. Restricted cubic splines examined dose–response. Mediation analysis quantified the roles of systemic immune-inflammation index (SII) and C-reactive protein (CRP). Kaplan-Meier and Cox models evaluated all-cause and cardiovascular mortality by DI-GM (>4 vs 1–4).</div></div><div><h3>Results</h3><div>Compared to DI-GM 1–3, scores of 5 and ≥6 were associated with 21–40 % lower odds of HF (adjusted OR 0.79, p = 0.034; OR 0.60, p = 2.3 × 10<sup>−5</sup>). Similar inverse associations were observed for diabetes, stroke, and kidney failure. Spline analysis revealed a nonlinear HF risk decline beyond scores of 4–5. Component-level analyses showed fiber and coffee were linked to significant reductions in CRP, SII and heart failure odds (fiber OR 0.85; coffee OR 0.77). Mediation by SII and CRP accounted for 26 % and 32 % of the DI-GM–HF association. Higher DI-GM (>4) predicted lower all-cause (HR 0.83; p < 0.001) and cardiovascular mortality (HR 0.71; p < 0.001).</div></div><div><h3>Conclusions</h3><div>Gut-microbiota–supportive diet (DI-GM ≥ 5) is linked to substantially lower prevalence of HF and related conditions, partly via reduced inflammation, and confers long-term survival benefits.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"27 ","pages":"Article 200529"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525656","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}

引用次数: 0

The value of pregnancy-related factors in the prediction of cardiovascular disease: a systematic review 妊娠相关因素在预测心血管疾病中的价值：系统综述

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2025-12-01 Epub Date: 2025-08-05 DOI: 10.1016/j.ijcrp.2025.200483

Zhixun Yang , Hendrikus J.A. van Os , Janet M. Kist , Rimke C. Vos , Hedwig M.M. Vos , Niels H. Chavannes , Annelieke H.J. Petrus

Aims

Pregnancy-related factors are associated with an increased risk of cardiovascular disease (CVD) and may help identify women at high cardiovascular risk. This study aims to provide an overview of prediction models for CVD which included pregnancy-related factors and to evaluate the impact of these factors on model performance.

Methods

PubMed and Embase were systematically searched until March 2023 for studies reporting on the development or validation of prediction models for CVD which included pregnancy-related factors. Data extraction was performed using the CHARMS checklist. Risk of bias was assessed using PROBAST.

Results

Seven studies were included. C-indices ranged between 0.63 and 0.79. Adding pregnancy-related factors resulted in improved C-index in four studies, ranging from 0.0033 (95 % confidence interval [CI]: 0.0022–0.0051) to 0.004 (95 % CI: 0.002–0.006). Net reclassification improvement (NRI) for events was improved in two studies, ranging from 0.01 (95 % CI: 0.003–0.02) to 0.038 (95 % CI: 0.003–0.074). NRI for non-events was improved in three studies, ranging from 0.002 (95 % CI: 0.0001–0.005) to 0.02 (95 % CI: 0.001–0.04). Two studies showed both low risk of bias and low concern regarding applicability. Subgroup analyses by age in three studies indicated larger improvements in model performance in younger women.

Conclusion

Addition of pregnancy-related factors results in limited improvements in performance of CVD prediction models, with relatively larger improvements in younger women.

目的妊娠相关因素与心血管疾病（CVD）风险增加相关，可能有助于识别心血管疾病高风险妇女。本研究旨在综述包括妊娠相关因素的CVD预测模型，并评估这些因素对模型性能的影响。方法系统检索spubmed和Embase数据库，直到2023年3月，检索包括妊娠相关因素的CVD预测模型开发或验证的研究报告。使用CHARMS检查表进行数据提取。使用PROBAST评估偏倚风险。结果共纳入7项研究。c指数在0.63 ~ 0.79之间。在四项研究中，加入妊娠相关因素导致c -指数改善，范围从0.0033（95%可信区间[CI]: 0.0022-0.0051）到0.004 （95% CI: 0.002-0.006）。在两项研究中，事件的净再分类改善（NRI）得到改善，范围从0.01 （95% CI: 0.003-0.02）到0.038 （95% CI: 0.003-0.074）。在三项研究中，非事件的NRI得到改善，范围从0.002 （95% CI: 0.0001-0.005）到0.02 （95% CI: 0.001-0.04）。两项研究均显示低偏倚风险和对适用性的低关注。三项研究中按年龄划分的亚组分析表明，年轻女性在模特表现方面的改善更大。结论妊娠相关因素的加入导致CVD预测模型性能的改善有限，年轻女性的改善相对较大。

{"title":"The value of pregnancy-related factors in the prediction of cardiovascular disease: a systematic review","authors":"Zhixun Yang , Hendrikus J.A. van Os , Janet M. Kist , Rimke C. Vos , Hedwig M.M. Vos , Niels H. Chavannes , Annelieke H.J. Petrus","doi":"10.1016/j.ijcrp.2025.200483","DOIUrl":"10.1016/j.ijcrp.2025.200483","url":null,"abstract":"<div><h3>Aims</h3><div>Pregnancy-related factors are associated with an increased risk of cardiovascular disease (CVD) and may help identify women at high cardiovascular risk. This study aims to provide an overview of prediction models for CVD which included pregnancy-related factors and to evaluate the impact of these factors on model performance.</div></div><div><h3>Methods</h3><div>PubMed and Embase were systematically searched until March 2023 for studies reporting on the development or validation of prediction models for CVD which included pregnancy-related factors. Data extraction was performed using the CHARMS checklist. Risk of bias was assessed using PROBAST.</div></div><div><h3>Results</h3><div>Seven studies were included. C-indices ranged between 0.63 and 0.79. Adding pregnancy-related factors resulted in improved C-index in four studies, ranging from 0.0033 (95 % confidence interval [CI]: 0.0022–0.0051) to 0.004 (95 % CI: 0.002–0.006). Net reclassification improvement (NRI) for events was improved in two studies, ranging from 0.01 (95 % CI: 0.003–0.02) to 0.038 (95 % CI: 0.003–0.074). NRI for non-events was improved in three studies, ranging from 0.002 (95 % CI: 0.0001–0.005) to 0.02 (95 % CI: 0.001–0.04). Two studies showed both low risk of bias and low concern regarding applicability. Subgroup analyses by age in three studies indicated larger improvements in model performance in younger women.</div></div><div><h3>Conclusion</h3><div>Addition of pregnancy-related factors results in limited improvements in performance of CVD prediction models, with relatively larger improvements in younger women.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"27 ","pages":"Article 200483"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809988","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}

引用次数: 0

The impact of chronic kidney disease on the antithrombotic strategies and outcomes in patients with acute coronary syndromes and atrial fibrillation: Insights from STAR-ACS study 慢性肾脏疾病对急性冠状动脉综合征和心房颤动患者抗血栓策略和结果的影响：来自STAR-ACS研究的见解

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2025-12-01 Epub Date: 2025-08-05 DOI: 10.1016/j.ijcrp.2025.200486

Kentaro Yasuda , Hiroshi Iwata , Katsumi Miyauchi , Shuko Nojiri , Yuji Nishizaki , Yuichi Chikata , Tohru Minamino , Hiroyuki Daida , STAR-ACS investigators

Background

Patients with acute coronary syndrome (ACS) and atrial fibrillation (AF) (ACS + AF) face elevated risks of thrombotic and bleeding events, especially with comorbid chronic kidney disease (CKD). Limited research has assessed the combined influence of CKD in this high-risk population.

Methods

This first subanalysis of STAR-ACS study included 445 Japanese ACS + AF patients, stratified by CKD status (eGFR < vs. ≥ 60 mL/min/1.73 m², CKD (+) vs. (−) groups, respectively). Antithrombotic therapy was assessed at baseline, one year, and two years. Primary outcomes included major bleeding and major adverse cardiovascular events.

Results

CKD prevalence was high at 56.4 %. While ratio of dual antiplatelet therapy had drastically decreased by two years, there was no significant difference between CKD (+) and (−) groups. In contrast, among anticoagulants, warfarin was preferably used in CKD (+) group, compared to CKD (−) group, remaining stable for 2 years. Direct oral anticoagulants (DOACs) were prescribed less frequently in CKD patients, with rivaroxaban usage notably lower in CKD (+), while apixaban usage numerically increased in CKD patients. Moreover, CKD was associated with a higher cumulative incidence of adverse outcomes, although this was not statistically significant. However, in DOACs-treated patients, CKD was significantly linked to poorer outcomes, with higher eGFR levels correlating with reduced risk.

Conclusions

This real-world data of ACS + AF patients indicated the significant influence of CKD on anticoagulant choice and on the worse outcome trends. These findings highlight the need for tailored antithrombotic strategies in patients with ACS, AF, and CKD to mitigate bleeding and thrombotic risks.

背景：急性冠脉综合征（ACS）和心房颤动（AF）（ACS + AF）患者面临血栓形成和出血事件的高风险，特别是合并慢性肾脏疾病（CKD）。有限的研究评估了CKD对这一高危人群的综合影响。方法STAR-ACS研究的第一个亚分析包括445名日本ACS + AF患者，按CKD状态(eGFR和lt；与≥60毫升/分钟/ 1.73平方米,CKD(+)和(−)组,分别)。抗血栓治疗在基线、1年和2年进行评估。主要结局包括主要出血和主要不良心血管事件。结果sckd患病率为56.4%。虽然双重抗血小板治疗的比例在两年内急剧下降，但CKD（+）组和（-）组之间没有显著差异。相比之下，在抗凝剂中，与CKD（−）组相比，CKD（+）组优先使用华法林，保持稳定2年。直接口服抗凝剂（DOACs）在CKD患者中的使用频率较低，利伐沙班在CKD患者中的使用明显较低（+），而阿哌沙班在CKD患者中的使用数量增加。此外，CKD与较高的不良结局累积发生率相关，尽管这没有统计学意义。然而，在doacs治疗的患者中，CKD与较差的预后显著相关，eGFR水平较高与风险降低相关。结论ACS + AF患者的真实数据表明，CKD对抗凝剂选择和不良结局趋势有显著影响。这些发现强调了ACS、AF和CKD患者需要量身定制的抗血栓策略，以减轻出血和血栓风险。

{"title":"The impact of chronic kidney disease on the antithrombotic strategies and outcomes in patients with acute coronary syndromes and atrial fibrillation: Insights from STAR-ACS study","authors":"Kentaro Yasuda , Hiroshi Iwata , Katsumi Miyauchi , Shuko Nojiri , Yuji Nishizaki , Yuichi Chikata , Tohru Minamino , Hiroyuki Daida , STAR-ACS investigators","doi":"10.1016/j.ijcrp.2025.200486","DOIUrl":"10.1016/j.ijcrp.2025.200486","url":null,"abstract":"<div><h3>Background</h3><div>Patients with acute coronary syndrome (ACS) and atrial fibrillation (AF) (ACS + AF) face elevated risks of thrombotic and bleeding events, especially with comorbid chronic kidney disease (CKD). Limited research has assessed the combined influence of CKD in this high-risk population.</div></div><div><h3>Methods</h3><div>This first subanalysis of STAR-ACS study included 445 Japanese ACS + AF patients, stratified by CKD status (eGFR < vs. ≥ 60 mL/min/1.73 m<sup>2</sup>, CKD (+) vs. (−) groups, respectively). Antithrombotic therapy was assessed at baseline, one year, and two years. Primary outcomes included major bleeding and major adverse cardiovascular events.</div></div><div><h3>Results</h3><div>CKD prevalence was high at 56.4 %. While ratio of dual antiplatelet therapy had drastically decreased by two years, there was no significant difference between CKD (+) and (−) groups. In contrast, among anticoagulants, warfarin was preferably used in CKD (+) group, compared to CKD (−) group, remaining stable for 2 years. Direct oral anticoagulants (DOACs) were prescribed less frequently in CKD patients, with rivaroxaban usage notably lower in CKD (+), while apixaban usage numerically increased in CKD patients. Moreover, CKD was associated with a higher cumulative incidence of adverse outcomes, although this was not statistically significant. However, in DOACs-treated patients, CKD was significantly linked to poorer outcomes, with higher eGFR levels correlating with reduced risk.</div></div><div><h3>Conclusions</h3><div>This real-world data of ACS + AF patients indicated the significant influence of CKD on anticoagulant choice and on the worse outcome trends. These findings highlight the need for tailored antithrombotic strategies in patients with ACS, AF, and CKD to mitigate bleeding and thrombotic risks.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"27 ","pages":"Article 200486"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144841096","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}

引用次数: 0

Electrocardiographic markers of arrhythmogenic risk in patients with isolated coronary artery ectasia 孤立性冠状动脉扩张患者致心律失常危险的心电图标志物

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2025-12-01 Epub Date: 2025-08-13 DOI: 10.1016/j.ijcrp.2025.200492

Forouzan Salari , Hossein Nough , Seyed Mostafa Seyedhosseini , Seyedeh Mahdieh Namayandeh

Background

Coronary artery ectasia (CAE) is an uncommon finding with potential clinical implications, including arrhythmogenic risk. Electrocardiographic parameters such as QT dispersion (QTd) and P wave dispersion (PWD) have been proposed as non-invasive predictors of electrical instability. This study aimed to compare ECG findings, between patients with isolated CAE and those with normal coronary arteries.

Methods

In this case-control study, 23 patients with isolated CAE (Group 1) and 26 patients with angiographically normal coronary arteries (Group 2) were enrolled. Groups were matched for age, gender, cardiovascular risk factors, and ejection fraction. Patients with conditions or medications affecting conduction were excluded. ECG parameters were compared using Chi-square and unpaired t-tests. Additional subgroup analyses using ANOVA, Spearman correlation, and linear mixed models were performed.

Results

T wave inversion was significantly more common in Group 1 than Group 2 (52.2 % vs. 11.5 %, P = 0.006). QTc was significantly prolonged in Group 1 (P = 0.046). QTd, QTcd, and PWD were all significantly greater in Group 1 (P < 0.05). QTd, QTcd, and PWD were positively correlated with the number of ectatic vessels (P < 0.001). However, PR interval, QRS duration, and QTc did not show significant associations. ECG parameters did not significantly differ based on the specific ectatic vessel. Significant variation in QTd, QTcd, and PWD was observed across different Markis types.

Conclusions

Patients with isolated CAE exhibit greater QT dispersion and P wave dispersion compared to controls, suggesting a higher arrhythmogenic potential. These parameters also correlate with the extent and classification of ectasia, highlighting their potential utility in risk stratification.

背景冠状动脉扩张（CAE）是一种罕见的发现，具有潜在的临床意义，包括致心律失常的风险。心电图参数如QT离散度（QTd）和P波离散度（PWD）已被提出作为电不稳定性的无创预测指标。本研究旨在比较孤立CAE患者和冠状动脉正常患者的心电图表现。方法选取23例孤立CAE患者（1组）和26例冠状动脉造影正常患者（2组）作为病例对照研究对象。各组根据年龄、性别、心血管危险因素和射血分数进行匹配。排除有影响传导的疾病或药物的患者。心电图参数比较采用卡方检验和非配对t检验。使用方差分析、Spearman相关和线性混合模型进行额外的亚组分析。结果1组st波反转发生率明显高于2组（52.2%比11.5%,P = 0.006）。第1组QTc明显延长（P = 0.046）。第1组QTd、QTcd、PWD均显著增高(P <；0.05)。QTd、QTcd、PWD与扩张血管数呈正相关(P <；0.001)。PR间期、QRS持续时间和QTc无显著相关性。不同扩张血管的心电图参数无明显差异。QTd、QTcd和PWD在不同Markis类型中存在显著差异。结论孤立性CAE患者QT离散度和P波离散度均高于对照组，提示有较高的致心律失常电位。这些参数也与扩张的程度和分类相关，突出了它们在风险分层中的潜在效用。

{"title":"Electrocardiographic markers of arrhythmogenic risk in patients with isolated coronary artery ectasia","authors":"Forouzan Salari , Hossein Nough , Seyed Mostafa Seyedhosseini , Seyedeh Mahdieh Namayandeh","doi":"10.1016/j.ijcrp.2025.200492","DOIUrl":"10.1016/j.ijcrp.2025.200492","url":null,"abstract":"<div><h3>Background</h3><div>Coronary artery ectasia (CAE) is an uncommon finding with potential clinical implications, including arrhythmogenic risk. Electrocardiographic parameters such as QT dispersion (QTd) and P wave dispersion (PWD) have been proposed as non-invasive predictors of electrical instability. This study aimed to compare ECG findings, between patients with isolated CAE and those with normal coronary arteries.</div></div><div><h3>Methods</h3><div>In this case-control study, 23 patients with isolated CAE (Group 1) and 26 patients with angiographically normal coronary arteries (Group 2) were enrolled. Groups were matched for age, gender, cardiovascular risk factors, and ejection fraction. Patients with conditions or medications affecting conduction were excluded. ECG parameters were compared using Chi-square and unpaired t-tests. Additional subgroup analyses using ANOVA, Spearman correlation, and linear mixed models were performed.</div></div><div><h3>Results</h3><div>T wave inversion was significantly more common in Group 1 than Group 2 (52.2 % vs. 11.5 %, <em>P</em> = 0.006). QTc was significantly prolonged in Group 1 (<em>P</em> = 0.046). QTd, QTcd, and PWD were all significantly greater in Group 1 (<em>P</em> < 0.05). QTd, QTcd, and PWD were positively correlated with the number of ectatic vessels (<em>P</em> < 0.001). However, PR interval, QRS duration, and QTc did not show significant associations. ECG parameters did not significantly differ based on the specific ectatic vessel. Significant variation in QTd, QTcd, and PWD was observed across different Markis types.</div></div><div><h3>Conclusions</h3><div>Patients with isolated CAE exhibit greater QT dispersion and P wave dispersion compared to controls, suggesting a higher arrhythmogenic potential. These parameters also correlate with the extent and classification of ectasia, highlighting their potential utility in risk stratification.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"27 ","pages":"Article 200492"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144841149","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}

引用次数: 0