IJC Heart and Vasculature最新文献

{"title":"Beyond circulating cGMP: revisiting compartmentalized signaling in HFrEF","authors":"Rene Pütz , Melissa Herwig , Simin Delalat , Innas Sultana , Ibrahim Akin , Nazha Hamdani , Ibrahim El-Battrawy","doi":"10.1016/j.ijcha.2026.101880","DOIUrl":"10.1016/j.ijcha.2026.101880","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"63 ","pages":"Article 101880"},"PeriodicalIF":2.5,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090740","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}

{"title":"Association between treatment-induced changes in the Kansas City Cardiomyopathy Questionnaire and clinical outcomes in chronic heart failure: a trial-level meta-regression analysis","authors":"Hidekatsu Fukuta ,&nbsp;Toshihiko Goto","doi":"10.1016/j.ijcha.2026.101881","DOIUrl":"10.1016/j.ijcha.2026.101881","url":null,"abstract":"<div><h3>Background</h3><div>Patient-reported outcomes such as the Kansas City Cardiomyopathy Questionnaire (KCCQ) are increasingly recognized for their prognostic value. While the composite endpoint of cardiovascular death and heart failure (HF) hospitalization is the standard primary outcome in contemporary HF trials, the potential for KCCQ changes to serve as an intermediate endpoint for these clinical events requires further evaluation.</div></div><div><h3>Methods</h3><div>We conducted a trial-level meta-regression analysis of phase 3 randomized controlled trials (RCTs) evaluating pharmacological therapies for chronic HF that reported both changes in KCCQ and the primary composite endpoint of cardiovascular death and HF hospitalization. Weighted random-effects meta-regression models were used to assess the association between changes in KCCQ scores and treatment effects on clinical outcomes.</div></div><div><h3>Results</h3><div>Twelve phase 3 RCTs were included, comprising eight enrolling patients with HF with reduced ejection fraction and four enrolling those with preserved ejection fraction. Changes in KCCQ scores were significantly associated with treatment effects on the primary composite endpoint (regression coefficient [95% CI] = −0.0611 [−0.0930, −0.0292]; p = 0.001; I² = 2.2%), cardiovascular death (−0.0676 [−0.1099, −0.0254]; p = 0.004; I² = 0%), and HF hospitalization (−0.0700 [−0.1322, −0.0775]; p = 0.031; I² = 54%).</div></div><div><h3>Conclusion</h3><div>Treatment-induced changes in KCCQ scores are significantly correlated with clinical outcomes in phase 3 HF trials. These findings support KCCQ as a promising candidate intermediate endpoint that provides supportive evidence for the clinical benefit of HF therapies. However, our results remain hypothesis-generating, and further validation using individual patient data and cross-mechanism studies is warranted before KCCQ can be formally established as a regulatory surrogate endpoint.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"63 ","pages":"Article 101881"},"PeriodicalIF":2.5,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090739","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}

{"title":"Rhythm control in persistent atrial fibrillation improves endothelial function without uniform anti-inflammatory effects: A 9-month prospective cohort study","authors":"Maximilian Seidel,&nbsp;David Bogdahn,&nbsp;Felix S. Seibert,&nbsp;Moritz Anft,&nbsp;Sarah Skrzypczyk,&nbsp;Ulrik Stervbo,&nbsp;Eva Kohut,&nbsp;Kamil Rosiewicz,&nbsp;Benjamin Sasko,&nbsp;Christian Ukena,&nbsp;Nina Babel,&nbsp;Timm H. Westhoff","doi":"10.1016/j.ijcha.2026.101879","DOIUrl":"10.1016/j.ijcha.2026.101879","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) is associated with systemic inflammation, endothelial dysfunction, and adverse cardiovascular outcomes. While there is robust evidence, that inflammation contributes to AF pathogenesis, the existence of a reverse relation – whether AF contributes to inflammation − remains elusive. This study therefore evaluates the impact of rhythm control on systemic inflammation and endothelial function.</div></div><div><h3>Methods</h3><div>In this prospective observational study, 124 patients with persistent AF undergoing successful rhythm control therapy (electrical cardioversion or catheter ablation) were followed for nine months. Various Cytokines, high-sensitivity C-reactive protein (hsCRP), flow-mediated dilation (FMD) and additional inflammatory biomarkers were measured at baseline, 1 week, 1 month, 3 months, and 9 months. FMD was assessed by high-resolution brachial artery ultrasound. Patients with AF recurrence throughout the follow-up period were excluded from primary analysis.</div></div><div><h3>Results</h3><div>In patients without AF recurrence, FMD improved significantly from 6.3 % (4.6–8.3) to 7.6 % (5.1–8.8) (p &lt; 0.001). HsCRP, IL-8 and fibrinogen declined modestly (p = 0.002, p &lt; 0.001 and p &lt; 0.001, respectively), whereas IL-2, IP-10, IL-12p70, MCP-1 and TNF-α increased significantly over time (all p &lt; 0.001). Elevated pre-treatment hsCRP was weakly associated with AF recurrence (r = 0.20, p = 0.023; AUC = 0.61). IL-6 showed temporal variation but no sustained change from baseline.</div></div><div><h3>Conclusion</h3><div>Rhythm control therapy in persistent AF is associated with an improvement of endothelial function but not with a homogeneous improvement of systemic inflammatory serological profiles. Thus, the improvement in FMD appears to be mediated primarily by hemodynamic restoration rather than anti-inflammatory effects.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"63 ","pages":"Article 101879"},"PeriodicalIF":2.5,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039967","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}

{"title":"Prognostic significance of subsequent decline in LVEF in heart failure with improved ejection fraction − A report from the CHART-2 study −","authors":"Takuya Takigahira ,&nbsp;Kotaro Nochioka ,&nbsp;Satoshi Miyata ,&nbsp;Takashi Shiroto ,&nbsp;Takumi Inoue ,&nbsp;Kai Susukita ,&nbsp;Hideka Hayashi ,&nbsp;Hiroyuki Takahama ,&nbsp;Jun Takahashi ,&nbsp;Hiroaki Shimokawa ,&nbsp;Satoshi Yasuda","doi":"10.1016/j.ijcha.2026.101877","DOIUrl":"10.1016/j.ijcha.2026.101877","url":null,"abstract":"<div><h3>Background</h3><div>Some patients of heart failure with improved ejection fraction (HFimpEF) have subsequent decline in left ventricular ejection fraction (LVEF) after improvement, and their prognosis is uncertain.</div></div><div><h3>Aims</h3><div>We aimed to examine the clinical characteristics and long-term prognosis of this sub-population of HFimpEF.</div></div><div><h3>Methods</h3><div>We examined 399 consecutive patients with HF with reduced ejection fraction (HFrEF, LVEF ≤ 40 %) with LVEF data at both baseline and follow-up in the CHART-2 Study. We classified them as follows; persistent HFrEF group (LVEF ≤ 40 % at 1-year and 2-year follow-up, n = 238), temporary HFimpEF group (≥10 % increase from baseline with LVEF &gt; 40 % at 1-year follow-up but LVEF ≤ 40 % at 2-year follow-up, n = 22), and persistent HFimpEF group (≥10 % increase from baseline with LVEF &gt; 40 % at 1-year follow-up, and LVEF &gt; 40 % at 2-year follow-up, n = 139).</div></div><div><h3>Results</h3><div>The temporary HFimpEF group (adjusted hazard ratio: 2.95; 95 % CI: 1.55–5.63) and the persistent HFrEF group (2.53; 1.75–3.67) were associated with increased risks for the composite of cardiovascular death and HF hospitalization. The risk factors for decline in LVEF included LVEF (adjusted odds ratio: 0.80; 95 %CI: 0.69–0.90), LV end-diastolic dimension (LVDd) (1.14; 1.05–1.25), B-type natriuretic peptide (BNP) levels (1.04 per 10 pg/mL increase; 1.00–1.08), estimated glomerular filtration rate (eGFR) levels (0.95; 0.92–0.99) and serum sodium levels (0.70; 0.50–0.91) at 1-year follow-up.</div></div><div><h3>Conclusions</h3><div>These results indicate that patients with HFrecEF account for 23% of those with HFrEF and that 12% of them have subsequent decline in LVEF associated with similar worse prognosis as in those with persistent HFrEF.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101877"},"PeriodicalIF":2.5,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022365","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}

{"title":"Serum aminoterminal type III procollagen peptide reflects increased vascular thickness in healthy, young adults","authors":"Manar Bitar ,&nbsp;Dieter Samyn ,&nbsp;Madeleine Helgesson ,&nbsp;Martin Vink ,&nbsp;Paul Pettersson-Pablo","doi":"10.1016/j.ijcha.2026.101876","DOIUrl":"10.1016/j.ijcha.2026.101876","url":null,"abstract":"<div><h3>Background</h3><div>Procollagen III, aminoterminal peptide (PIIINP) is a degradation product of collagen type III-synthesis. Collagen type III is distributed in many tissues, and an increase in serum PIIINP could reflect an increase in collagen turnover and pro-fibrotic activity. In this study, on a population of younger, healthy adults, we examined whether serum PIIINP correlates with early markers of vascular health, to evaluate its potential as a biomarker for early screening of preclinical cardiovascular risk.</div></div><div><h3>Methods</h3><div>PIIINP levels, pulse wave velocity (PWV) and Carotid-intima media thickness (cIMT) was measured in 834 healthy, non-smoking, individuals aged 18–26. In univariable and multivariable linear regression models, we examined the association between PIIINP and vascular measurements, PWV and cIMT with adjustment for serum lipids, liver enzymes and systolic blood pressure.</div></div><div><h3>Results</h3><div>The average of PIIINP, PWV and cIMT measurements in this population, were low (7.1 and 7.3 µg/L, 5.5 and 5.2 m/s, and 0.50 and 0.49 mm for men and women, respectively). In univariable analyses, PIIINP correlated positively with cIMT (p = 0.0061) and negatively with PWV (p = 0.0069). In multivariable analyses, a statistically significant association remained between PIIINP and cIMT (p &lt; 0.001), but not with PWV.</div></div><div><h3>Conclusion</h3><div>Serum PIIINP correlates with cIMT in a healthy population, indicating its potential as a biomarker of cardiovascular risk at a preclinical stage. PIIINP measurement being easier to perform and less examiner dependent than the more time consuming and cumbersome cIMT, are suggestive of its possible merits as an early screening tool for cardiovascular disease.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101876"},"PeriodicalIF":2.5,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022368","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}

{"title":"Prognostic value of liver shear wave elastography after transcatheter aortic valve implantation in severe aortic stenosis","authors":"Yutaro Sato ,&nbsp;Akihiko Sato ,&nbsp;Kazuya Sakamoto ,&nbsp;Yuuki Muto ,&nbsp;Yu Sato ,&nbsp;Tetsuro Yokokawa ,&nbsp;Takeshi Shimizu ,&nbsp;Tomofumi Misaka ,&nbsp;Takashi Kaneshiro ,&nbsp;Masayoshi Oikawa ,&nbsp;Atsushi Kobayashi ,&nbsp;Akiomi Yoshihisa ,&nbsp;Yasuchika Takeishi","doi":"10.1016/j.ijcha.2025.101864","DOIUrl":"10.1016/j.ijcha.2025.101864","url":null,"abstract":"<div><h3>Background</h3><div>Shear wave elastography (SWE) is a noninvasive ultrasound technique that quantifies liver stiffness. Previous studies have suggested that liver SWE can serve as an indirect marker of hepatic congestion. However, it remains unclear whether liver SWE measured after transcatheter aortic valve implantation (TAVI) is associated with clinical outcomes.</div></div><div><h3>Methods</h3><div>A total of 127 consecutive patients with severe aortic stenosis who underwent TAVI and had liver SWE measured using abdominal ultrasonography at discharge were enrolled. Liver SWE was obtained from the right hepatic lobe via an intercostal approach. Patients were stratified by the median liver SWE value (1.36 m/s): low-SWE group (&lt; 1.36 m/s; <em>n</em> = 59) and high-SWE group (≥ 1.36 m/s; <em>n</em> = 68). The primary endpoint was a composite of all-cause death and heart failure (HF) rehospitalization.</div></div><div><h3>Results</h3><div>All 127 patients were followed for 24 months, during which 21 (16.5 %) experienced the primary endpoint. Kaplan–Meier analysis showed a higher cumulative incidence of the primary endpoint in the high-SWE group than in the low-SWE group (log-rank <em>P</em> = 0.019). In Cox proportional hazards models adjusted using inverse probability of treatment weighting, high liver SWE was independently associated with an increased risk of the primary endpoint (hazard ratio 3.66; 95 % confidence interval 1.30–10.32; <em>P</em> = 0.014).</div></div><div><h3>Conclusion</h3><div>High liver SWE after TAVI was independently associated with an increased 24-month risk of all-cause death and HF rehospitalization.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101864"},"PeriodicalIF":2.5,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022366","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}

{"title":"Visual coronary calcium scoring to support opportunistic CAD screening: comparative evaluation of three established systems and introduction of a novel scoring system","authors":"Philipp Nicol ,&nbsp;Rafael Adolf ,&nbsp;Salvatore Cassese ,&nbsp;Adnan Kastrati ,&nbsp;Michael Joner ,&nbsp;Heribert Schunkert ,&nbsp;Martin Hadamitzky ,&nbsp;Leif-Christopher Engel","doi":"10.1016/j.ijcha.2026.101875","DOIUrl":"10.1016/j.ijcha.2026.101875","url":null,"abstract":"<div><h3>Background</h3><div>Coronary artery calcium (CAC) scoring is an established marker of atherosclerotic burden and cardiovascular risk. While the Agatston score is the clinical gold standard, alternative visual scoring methods—including the Visual Ordinal Score, Weston Score, and Vessel-specific extent-based score—are increasingly used, particularly in non-gated or opportunistic CT imaging. This study aimed to compare the diagnostic performance, inter-observer reliability, and correlation of different visual scoring methods against the Agatston score.</div></div><div><h3>Methods</h3><div>A total of 299 cases were evaluated using ECG-gated CT scans. Each case was independently scored in a blinded fashion by two observers using three visual methods: (1) Visual Ordinal Score (VS), (2) Weston Score (WS) and (3) Vessel-specific extent-based score (VSES). A novel visual CAC score was derived by combining Weston and Vessel-specific extent-based scoring (= Weston Extent Score, WES). Cohen’s Kappa and Intraclass Correlation Coefficients (ICC) were used for inter-observer agreement. Classification performance was assessed against Agatston-based categories (No CAC, Mild, Moderate, Severe), including accuracy, precision, sensitivity, and specificity. Correlation analyses were conducted using Pearson and Spearman coefficients.</div></div><div><h3>Results</h3><div>All scoring methods showed high correlation with the Agatston score (Spearman ρ &gt; 0.87; p &lt; 0.001). Visual scoring demonstrated the highest inter-observer agreement (Kappa = 0.94, ICC = 0.97), followed by Weston (Kappa = 0.90) and Vessel-Specific scores (Kappa = 0.77). Visual scoring also yielded the highest accuracy (Observer 1: 91.3 %, Observer 2: 90.0 %) The newly derived WES score achieved 80.9 % accuracy, with macro-averaged specificity of 93.8 % and improving diagnostic accuracy compared to WS and VSES.</div></div><div><h3>Discussion</h3><div>Different visual scoring offers excellent reproducibility and diagnostic accuracy for CAC classification, with strong correlation to the Agatston score. The newly-derived WES score could be useful in providing a practical balance regarding volumetric information (CAC densitiy) and anatomical distribution of CAC. These findings support the implementation of structured visual CAC scoring in clinical and opportunistic CT settings.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101875"},"PeriodicalIF":2.5,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022367","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}

{"title":"Clinical outcomes of SGLT2 inhibitor use in Thai patients with heart failure: a five-year retrospective cohort study","authors":"Thananan Chanchanayothin ,&nbsp;Chuttikan Klomwong ,&nbsp;Tanawit Saisri ,&nbsp;Suphasin Panudom ,&nbsp;Sakchai Chaiyamahapurk ,&nbsp;Nonthikorn Theerasuwipakorn ,&nbsp;Noppachai Siranart ,&nbsp;Patavee Pajareya ,&nbsp;Nattakorn Songsirisuk ,&nbsp;Chalinee Pravarnpat ,&nbsp;Akenarong Pipatputthapong ,&nbsp;Pongpun Jittham ,&nbsp;Paisit Kosum","doi":"10.1016/j.ijcha.2026.101873","DOIUrl":"10.1016/j.ijcha.2026.101873","url":null,"abstract":"<div><h3>Introduction &amp; Objectives</h3><div>Heart failure is one of the major public health concerns and a leading cause of hospitalization and mortality worldwide, including in Thailand. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have demonstrated significant cardiovascular benefits in clinical trials. This study aimed to evaluate the real-world effectiveness of SGLT2i in reducing all-cause mortality and heart failure hospitalization among patients with heart failure at Naresuan University Hospital.</div></div><div><h3>Materials &amp; Methods</h3><div>This retrospective cohort study included patients newly diagnosed with heart failure at Naresuan University Hospital between January 1, 2019, and December 31, 2023. Patients were divided into those who received SGLT2i and those who did not. The primary outcome was a composite of all-cause mortality and hospitalization for worsening heart failure. Rate ratios were calculated using multilevel mixed-effects Poisson regression, adjusting for baseline characteristics.</div></div><div><h3>Results</h3><div>A total of 1,378 patients were included (1,080 SGLT2i visits; 5,243 non-SGLT2i visits). The proportion of patients with reduced left ventricular ejection fraction (LVEF ≤ 40%) was higher in the SGLT2i group than the non-SGLT2i group (39.9% vs. 29.4%, p &lt; 0.001). The SGLT2i group also had a higher prevalence of coronary artery disease, myopathy, and chronic kidney disease. Rate of composite outcome (death or heart failure hospitalization) was lower in the SGLT2i group (rate 10.93 per 100 vs. 17.58 per 100). The incidence of the composite outcome was significantly lower in the SGLT2i group compared to the non-SGLT2i group (rate ratio 0.60, 95% CI: 0.42–0.87; p = 0.006). The all-cause mortality rate in the SGLT2i group was markedly lower (rate ratio 0.02, 95% CI: 0.00–0.18; p = 0.001), while heart failure hospitalization showed a favorable trend without reaching statistical significance.</div></div><div><h3>Conclusion</h3><div>SGLT2i were associated with a significantly lower risk of death and heart failure hospitalization in this real-world cohort of Thai heart failure patients. These findings reinforce the clinical benefits of SGLT2i and support their broader implementation in heart failure management in Thailand.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101873"},"PeriodicalIF":2.5,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022482","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}

{"title":"Prognostic value of psoas muscle area and pleural effusion in patients undergoing TAVI","authors":"Otto Järvinen ,&nbsp;Jani Rankinen ,&nbsp;Jussi Hernesniemi ,&nbsp;Marko Virtanen ,&nbsp;Pasi Maaranen ,&nbsp;Markku Eskola ,&nbsp;Niku Oksala ,&nbsp;Juho Tynkkynen","doi":"10.1016/j.ijcha.2026.101871","DOIUrl":"10.1016/j.ijcha.2026.101871","url":null,"abstract":"<div><h3>Background</h3><div>Radiographic markers such as psoas muscle area (PMA) and pleural effusion have been linked to mortality after transcatheter aortic valve implantation (TAVI). We examined their relationship with cause-specific mortality and their incremental prognostic value beyond EuroSCORE II.</div></div><div><h3>Methods</h3><div>This retrospective study included 1090 consecutive TAVI patients treated at Heart Hospital, Tampere University Hospital between 2008 and 2020. Preoperative CT scans were reviewed for L3-level PMA and pleural effusion (&gt;10 mm thickness). Subdistribution hazard models adjusted for age, sex, BMI, and BSA were used to analyze cause-specific mortality. Incremental prognostic value beyond EuroSCORE II was assessed using time-dependent discrimination indexes (AUC and IDI) and net-reclassification index (NRI) at 3 years.</div></div><div><h3>Results</h3><div>During a median follow-up of 4.3 years (IQR 3.1–6.0), 54% (n = 590) of patients died: 64% (n = 376) from cardiovascular, 30% (n = 177) from non-cardiovascular, and 6% (n = 37) from unnatural causes. PMA and pleural effusion were associated with cardiovascular mortality (PMA: SDH/1SD 0.88, 95% CI 0.78–0.99, p = 0.037; pleural effusion: SDH 1.73, 95% CI 1.37–2.19, p &lt; 0.001). Combined inclusion of PMA and pleural effusion improved NRI = 0.13 (p = 0.004) and IDI = 0.015 (p = 0.004) of overall mortality prediction compared to EuroSCORE II alone.</div></div><div><h3>Conclusions</h3><div>Psoas muscle area (PMA) and pleural effusion were independently associated with cardiovascular mortality after TAVI, whereas no significant associations were observed with non-cardiovascular deaths. Combined inclusion of these parameters led to a modest but not clinically meaningful improvement in the EuroSCORE II–based prediction of mortality.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101871"},"PeriodicalIF":2.5,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022361","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}

{"title":"Ascending aortic length across a large population presenting to the emergency room, a retrospective cross-sectional study","authors":"Thomas Saliba ,&nbsp;Gabriella Giandotti Gomar ,&nbsp;Olivier Cappeliez ,&nbsp;Yasser Alemán-Gómez ,&nbsp;Guillaume Fahrni ,&nbsp;David Rotzinger","doi":"10.1016/j.ijcha.2026.101874","DOIUrl":"10.1016/j.ijcha.2026.101874","url":null,"abstract":"<div><h3>Background</h3><div>Aortic dissection often occurs at diameters below surgical thresholds, underscoring the need for better predictive markers. Ascending aortic length has emerged as a potential morphologic risk factor, but normal population data are limited. This study aimed to establish normative aortic length values by age and sex and develop a tool to predict dissection risk.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 1030 (986 without and 44 with type A dissection) emergency room patients (from 1,445 screened) who underwent ECG-gated thoracic CT angiography between 2019 and 2025, excluding those with prior aortic surgery or disease. Ascending aortic length, from the sinotubular junction to the brachiocephalic trunk, was measured using semi-automated centerline tools. Logistic and LASSO regression models estimated type A dissection probability based on aortic length, age, height, and sex.</div></div><div><h3>Results</h3><div>Mean ascending aortic length was 70.7 ± 11.6 mm in men and 64.1 ± 11.4 mm in women. Patients with acute type A dissection (n = 44) had significantly longer aortas (men: 93.9 ± 20.5 mm; women: 90.0 ± 18.5 mm; p &lt; 0.001). Aortic length was the strongest independent predictor (OR = 1.13, 95 % CI 1.10–1.17, p &lt; 0.001). A reduced model including only aortic length showed excellent discrimination (AUC = 0.871; sensitivity = 0.773; specificity = 0.867; PPV = 0.206; NPV = 0.988).</div></div><div><h3>Conclusion</h3><div>Ascending aortic length increases with age and is markedly greater in patients with acute type A dissection. We provide normative reference tables by age and sex and a logistic model for individualized risk estimation of dissection at the time of the exam.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101874"},"PeriodicalIF":2.5,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022483","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}