IJC Heart and Vasculature最新文献

{"title":"Multimorbidity increases risk of cardiovascular outcomes in permanent atrial fibrillation: Data from the RACE II study","authors":"Colinda van Deutekom ,&nbsp;Marieke J.H. Velt ,&nbsp;Isabelle C. van Gelder,&nbsp;Michiel Rienstra,&nbsp;Bart A. Mulder,&nbsp;for the RACE II investigators","doi":"10.1016/j.ijcha.2025.101686","DOIUrl":"10.1016/j.ijcha.2025.101686","url":null,"abstract":"<div><h3>Introduction</h3><div>Multimorbidity is common in patients with atrial fibrillation (AF), but data on its prevalence and impact in permanent AF is limited. This study aimed to investigate the prevalence of multimorbidity and its association with cardiovascular outcomes in recent-onset permanent AF.</div></div><div><h3>Methods</h3><div>The RACE II study was a randomized controlled trial comparing strict and lenient rate-control in 614 patients with recent-onset permanent AF. Presence of nine comorbidities was assessed and the population divided into three groups based on the number of comorbidities (0–1, 2–3, ≥4). Cox regression analyses were conducted to assess the association between the number of comorbidities and the primary composite outcome (cardiovascular mortality, hospitalization for heart failure, stroke and/or systemic embolism, major bleeding, arrhythmic events). Kaplan-Meier estimates for the cumulative risk of the first event were calculated and plotted.</div></div><div><h3>Results</h3><div>Mean age was 68 ± 8 years and 211 (34 %) were women. In this population, 213 (35 %) patients had 0–1 comorbidity, 313 (51 %) 2–3, and 88 (14 %) ≥ 4. During 3 years follow-up, 81 patients (13 %) reached the primary composite outcome. Patients with more comorbidities more frequently reached the primary composite outcome (P &lt; 0.001), as well as cardiovascular mortality (P = 0.049), heart failure hospitalizations (P = 0.003), and stroke/systemic embolism (P = 0.024). The presence of ≥ 4 comorbidities was associated with a higher risk of the primary composite outcome compared to the presence of 0–1 comorbidity (HR 2.27, 95 % CI (1.21–4.23), P = 0.010).</div></div><div><h3>Conclusion</h3><div>Multimorbidity was present in two-thirds of recent-onset permanent AF patients, with a higher number of comorbidities associated with greater risk of cardiovascular outcomes.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101686"},"PeriodicalIF":2.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870858","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":"Comparison of mortality trends in patients with rheumatic mitral valve disease and nonrheumatic mitral valve disease: A retrospective study in US from 1999 to 2020","authors":"Eeman Ahmad ,&nbsp;Shahzaib Ahmed ,&nbsp;Sophia Ahmed ,&nbsp;Hamza Ashraf ,&nbsp;Umar Akram ,&nbsp;Shoaib Ahmad ,&nbsp;Irfan Ullah ,&nbsp;Mohammed Khanji ,&nbsp;Wael Awad ,&nbsp;Vuyisile Nkomo ,&nbsp;Fabrizio Ricci ,&nbsp;Matthew Bates ,&nbsp;Mohammad Alkhalil ,&nbsp;Raheel Ahmed ,&nbsp;Anwar A. Chahal","doi":"10.1016/j.ijcha.2025.101687","DOIUrl":"10.1016/j.ijcha.2025.101687","url":null,"abstract":"<div><div>Background: Mitral valve disease (MVD) can have both rheumatic and nonrheumatic etiologies. However, differences in mortality remain unknown. Methods: We extracted age-adjusted mortality rates (AAMRs) per 100,000 persons from the CDC WONDER database and stratified them by sex, region, and race. Annual percent change (APC) and average annual percent change (AAPC) were calculated using Joinpoint regression. Pairwise comparison was used to identify significant differences for MVD mortality trends between rheumatic and nonrheumatic patients. Results: From 1999 to 2020, a total of 72,085 deaths were recorded in patients with rheumatic MVD, while 132,300 occurred in those with nonrheumatic MVD. The AAMR for nonrheumatic patients was twice as high as that for rheumatic patients throughout the study period, and AAPC differed significantly between the groups (p &lt; 0.05). Females with rheumatic MVD were observed to have a higher AAMR (1.1) than their male counterparts (0.8), but those with nonrheumatic MVD exhibited a similar AAMR for both females and males. Among rheumatic patients, NH (non-hispanic) Whites were reported to have the highest AAMR (1.0), followed by NH Black or African Americans (0.8), Hispanic or Latinos (0.7), and NH Asian or Pacific Islanders (0.7). Among nonrheumatic patients, NH Whites exhibited the highest AAMR (1.9), followed by NH Black or African Americans (1.4), NH Asian or Pacific Islanders (1.1), and Hispanic or Latinos (1.0). The AAMR in Rural areas was higher than that in Urban areas for patients with both rheumatic and nonrheumatic MVD. Conclusion: Comprehensive public health strategies are essential to improving survival outcomes.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101687"},"PeriodicalIF":2.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870859","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":"Myocardial work parameters in left bundle branch area pacing versus other pacing techniques: a systematic review and aggregate comparative analysis","authors":"Raffaella Mistrulli ,&nbsp;Sara Gharehdaghi ,&nbsp;Arthur Iturriagagoitia ,&nbsp;Elayne Kelen de Oliveira ,&nbsp;Lucio Addeo ,&nbsp;Stefano Valcher ,&nbsp;Sara Corradetti ,&nbsp;Michele Mattia Viscusi ,&nbsp;Peter Peytchev ,&nbsp;Ward A. Heggermont ,&nbsp;Marc Vanderheyden ,&nbsp;Emanuele Barbato ,&nbsp;Guy Van Camp ,&nbsp;Martin Penicka","doi":"10.1016/j.ijcha.2025.101683","DOIUrl":"10.1016/j.ijcha.2025.101683","url":null,"abstract":"<div><div>Cardiac conduction disease often necessitates permanent pacemaker implantation. While right ventricular pacing (RVP) effectively treats bradycardia, it may lead to adverse cardiac remodeling and heart failure. Left bundle branch area pacing (LBBAP) has emerged as an alternative, potentially preserving myocardial function. Non-invasive myocardial work (MW) assessment provides valuable insights into left ventricular systolic function, energetics, and efficiency. This study systematically reviewed and analyzed MW parameters, comparing LBBAP to RVP and His bundle pacing (HBP). A meta-analysis of 241 patients across five studies examined four MW parameters—Global Work Index (GWI), Global Constructive Work (GCW), Global Wasted Work (GWW), and Global Work Efficiency (GWE)—at baseline, post-implantation, and last follow-up (median: 180 days, IQR: 7–360 days). At baseline, MW parameters were similar between LBBAP and RVP. Post-implantation, LBBAP preserved MW more effectively, showing significantly higher GWI than RVP (2250.0 ± 400.0 vs. 1600.0 ± 300.0 mmHg%, p = 0.027), a difference that remained significant at follow-up (p = 0.035). GWE was also significantly higher at follow-up (p = 0.011), while GCW and GWW showed no significant differences. MW parameters did not differ significantly between LBBAP and HBP (all p-values &gt;0.05). These findings suggest that LBBAP provides superior MW preservation compared to RVP, with significant benefits in GWI and GWE, while demonstrating comparable performance to HBP.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"58 ","pages":"Article 101683"},"PeriodicalIF":2.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143854918","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":"The impact of ascending aorta dilatation on transcatheter aortic valve implantation outcomes","authors":"Pandit Bagus Tri Saputra ,&nbsp;Wynne Widiarti ,&nbsp;Ali Mustofa ,&nbsp;Cornelia Ghea Savitri ,&nbsp;Johanes Nugroho Eko Putranto ,&nbsp;Faisal Yusuf Ashari ,&nbsp;Chaq El Chaq Zamzam Multazam ,&nbsp;Firas Farisi Alkaff ,&nbsp;Mario D’Oria","doi":"10.1016/j.ijcha.2025.101680","DOIUrl":"10.1016/j.ijcha.2025.101680","url":null,"abstract":"<div><div>The impact of ascending aorta dilatation (AAD) on transcatheter aortic valve implantation (TAVI) outcomes, compared to non-AAD, remains unclear. This <em>meta</em>-analysis aims to compare the outcomes of TAVI between patients with and without AAD. We systematically searched PubMed, ScienceDirect, Web of Science, Springer, Cochrane, and <span><span>Clinicaltrials.gov</span><svg><path></path></svg></span>. for articles up to 25 March 2024 (PROSPERO ID CRD42024526311). A total of 204,078 patients from ten studies were included. Paravalvular regurgitation (RR 1.56 95 %CI: 1.32–1.84, p &lt; 0.00001, I² = 0 %) and aortic dissection (RR 3.55 95 %CI: 1.79–7.06, p = 0.0003, I² = 40 %) were more common in AAD group. However, there were no differences in <em>peri</em>-procedural (RR 1.09, 95 %CI: 0.83–1.42, p = 0.53, I² = 0 %) and 1-year (RR 0.79, 95 %CI: 0.51–1.23, p = 0.30, I² = 0 %) mortality. Three-years (RR 0.88, 95 %CI: 0.54–1.44, p = 0.62) and five-years (RR 0.85, 95 %CI: 0.45–1.6, p = 0.61) follow-up showed comparable mortality between both groups. The other complications and the need for second valve implantation (RR 1.24, 95 %CI: 0.70–20.20, p = 0.48, I² = 65 %) were similar between both groups. Despite the higher incidence of aortic dissection and paravalvular regurgitation in AAD than in non-AAD patients, these complications were not associated with worse short-term or long-term mortality. Therefore, TAVI remains a safe and effective option for AAD patients.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"58 ","pages":"Article 101680"},"PeriodicalIF":2.5,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850722","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":"Impact of obesity on clinical outcomes in patients with high-risk pulmonary embolism: A comparative analysis","authors":"Ziv Shachar ,&nbsp;Marlon V. Gatuz ,&nbsp;Adam Folman ,&nbsp;Maguli S. Barel ,&nbsp;Rami Abu-Fanne ,&nbsp;Dmitry Abramov ,&nbsp;Mamas A. Mamas ,&nbsp;Ariel Roguin ,&nbsp;Ofer Kobo","doi":"10.1016/j.ijcha.2025.101682","DOIUrl":"10.1016/j.ijcha.2025.101682","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary embolism (PE) is a life-threatening cardiovascular condition with increasing global incidence. Obesity is a significant risk factor for PE, although its reported relationship with outcomes is inconsistent. This study aimed to investigate the impact of obesity on clinical outcomes in patients with high-risk PE.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of US adult patients hospitalized with high-risk PE from 2016 to 2019 using the National Inpatient Sample database. Patients were categorized into three groups based on BMI: non-obese, obese (30 to &lt; 40 kg/m²), and severely obese (≥40 kg/m²). We compared baseline characteristics, in-hospital procedures, and outcomes among these groups. Multivariable logistic regression models assessed the relationship between obesity levels and in-hospital outcomes.</div></div><div><h3>Results</h3><div>Of 752,660 patients with PE, 29,610 (3.9 %) were classified as high-risk. The distribution among BMI categories was: non-obese (77.1 %), obese (8.8 %), and severely obese (14.1 %).<!--> <!-->Severely obese patients were younger (mean age 55.7 vs. 66.1 years for non-obese, p &lt; 0.001) and more likely to be female (63.2 % vs. 51.4 % for non-obese, p &lt; 0.001). After adjustment, obese and severely obese patients had lower odds of in-hospital mortality (obese: aOR 0.50, p &lt; 0.001; severely obese: aOR 0.69, p &lt; 0.001) and major adverse cardiovascular and cerebrovascular events (obese: aOR 0.50, p &lt; 0.001; severely obese: aOR 0.72, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Our study revealed an “obesity paradox” in high-risk PE patients, with obese and severely obese individuals showing lower mortality and fewer complications despite higher comorbidity rates. These findings emphasize the need for tailored risk assessment and treatment strategies in obese patients with high-risk PE.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"58 ","pages":"Article 101682"},"PeriodicalIF":2.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843333","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":"Associations between pathophysiological traits and symptom development in retrospective analysis of V30M and V122I transthyretin amyloidosis","authors":"Sameer U. Kini ,&nbsp;Ha My Thi Vy ,&nbsp;Madhav Subramanian ,&nbsp;Parasuram M. Krishnamoorthy ,&nbsp;Son Q. Duong ,&nbsp;Ghislain Rocheleau ,&nbsp;Jagat Narula ,&nbsp;Ron Do ,&nbsp;Girish N. Nadkarni","doi":"10.1016/j.ijcha.2025.101663","DOIUrl":"10.1016/j.ijcha.2025.101663","url":null,"abstract":"<div><h3>Background</h3><div>The Val30Met (V30M) and Val122Ile (V122I) transthyretin (<em>TTR</em>) mutations often beget hereditary amyloid transthyretin amyloidosis (hATTR). Since symptoms are progressively debilitating and potentially fatal if untreated, low survival rates result from late diagnoses of hATTR patients. This retrospective analysis of microarray and biobank data helped establish clinical biomarkers for early hATTR detection.</div></div><div><h3>Methods</h3><div>In a Portuguese sample of V30M carriers (n = 183), gene profiling identified dysregulated immune markers. Among African Americans (AA) and Hispanic/Latinx Americans (HA) from the Mount Sinai Bio<em>Me</em> Biobank (n = 28,718), a case-control style Phenome-Wide Association Study (PheWAS; odds ratio [95% confidence interval]) of V122I for phenotypic and echocardiogram traits (β coefficients [95 % CI]) determined gene pleiotropy.</div></div><div><h3>Results</h3><div>Among V30M profiles, 96 (52.4%) were symptomatic, expressing upregulated neutrophil activity (p &lt; 10^-16), IL-6/JAK/STAT3 signaling (p &lt; 10^-3), and downregulated CD4⁺T cell expression (p = 0.009), compared to their asymptomatic counterparts. In Bio<em>Me</em>, 562 (2.0%) were V122I carriers, demonstrating associations with heart failure (1.71 [1.23–2.39]; p = 0.0014), amyloidosis (20.79 [8.42–51.31]; p = 4.67 × 10⁻¹¹), secondary/extrinsic cardiomyopathies (17.73 [7.25–43.37]; p = 2.97 × 10⁻¹⁰), peripheral nerve disorders (4.14 [2.42–7.09]; p = 2.26 × 10⁻⁷), primary angle-closure glaucoma (8.03 [3.15–20.46]; p = 1.27 × 10⁻⁵), malignant neoplasm of the female breast (4.48 [2.23–9.00]; p = 2.48 × 10⁻⁵), fracture of tibia and fibula (8.42 [3.25–21.89]; p = 1.19 × 10⁻⁵), and Carpal tunnel syndrome (2.62 [1.68–4.11]; p = 2.44 × 10⁻⁵). Echocardiographic presentations included higher LVEDV (15.87 [9.63–22.10]; p = 6.04 × 10⁻⁷) and LA length (1.52 [0.69–2.35]; p = 3.31 × 10⁻⁴). Race-stratified associations identified that AA presented more severe cardiac abnormalities than HA.</div></div><div><h3>Conclusions</h3><div>This study identified inflammatory biomarkers upregulated in symptomatic V30M carriers and phenotypic/echocardiographic traits associated with V122I, representing comorbidities of hATTR pathology. Such markers can provide the basis for future improvements in diagnostic regimes to deliver early therapies.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"58 ","pages":"Article 101663"},"PeriodicalIF":2.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828930","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":"Routine stress testing with subsequent coronary angiography versus standard of care in high-risk patients after percutaneous coronary intervention: An updated meta-analysis of randomized controlled trials","authors":"Umar G. Adamu ,&nbsp;David M. Mashilo ,&nbsp;Anupa Patel ,&nbsp;Nqoba Tsabedze","doi":"10.1016/j.ijcha.2025.101681","DOIUrl":"10.1016/j.ijcha.2025.101681","url":null,"abstract":"<div><div>Routine functional stress testing with subsequent coronary angiography is undertaking to detect early restenosis and guide revascularization in high-risk patients after percutaneous coronary intervention (PCI). However, the safety and efficacy of routine functional stress testing over standard care is still debatable. This <em>meta</em>-analysis compares routine functional stress testing vs. standard care in high-risk patients after PCI. We systematically searched PubMed, Embase, and Cochrane Central databases to identify randomized controlled trials (RCTs) that compared functional stress testing versus standard of care after PCI in high-risk patients from inception to January 2025. We calculated the risk ratios (RRs) with 95 % confidence intervals (CIs) using the random-effects model for clinical outcomes. Four RCTs with 6,290 patients, of whom 3,206 (51 %) underwent routine functional stress testing were included in our analyses. The incidence of target lesion revascularization (TLR) was higher in routine functional stress testing (RR: 1.49; 95 % CI: 1.02–2.18;<!--> <!-->p = 0.038) compared with standard care. However, no statistically significant difference was observed for individual outcomes of all-cause mortality (RR: 0.89; 95 % CI: 0.48–1.18;<!--> <!-->p = 0.198), myocardial infarction (MI) (RR: 0.62; 95 % CI: 0.31–1.24;<!--> <!-->p = 0.174), and hospitalization for any cause (RR: 1.22; 95 % CI: 0.24–6.10;<!--> <!-->p = 0.809). The risk of MACE did not significantly differ between the groups (RR: 1.11; 95 % CI: 0.82–1.51; p = 0.480). Routine functional stress testing after PCI in high-risk patients was associated with increased incidence of target lesion revascularization, without reducing the risk of major adverse cardiovascular events.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"58 ","pages":"Article 101681"},"PeriodicalIF":2.5,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821437","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 phenotypes of severe atrial cardiomyopathy and their outcome: A cluster analysis","authors":"R. Ilieva ,&nbsp;P. Kalaydzhiev ,&nbsp;B. Slavchev ,&nbsp;N. Spasova ,&nbsp;E. Kinova ,&nbsp;A. Goudev","doi":"10.1016/j.ijcha.2025.101679","DOIUrl":"10.1016/j.ijcha.2025.101679","url":null,"abstract":"<div><h3>Background</h3><div>Atrial cardiomyopathy (AtCM) encompasses patients with diverse demographics and comorbidities. This study aimed to identify phenotype groups with similar clinical characteristics, compare their mortality and atrial fibrillation (AF) event rates, and assess predictors of mortality.</div></div><div><h3>Methods and Results</h3><div>We performed a hierarchical cluster analysis using Ward’s Method, based on 11 clinical variables. Among 724 consecutive patients with a dilated left atrium (LA), only 196 met the criterion for severe AtCM- defined as a dilated LA with a volume index ≥ 50 ml/m2. We identified 4 clusters: Cluster 1 −younger overweight patients with paroxysmal AF; Cluster 2 −older patients with heart failure (HF) and low BMI; Cluster 3 − diabetic patients with HF; and Cluster 4 − older patients with tachycardia-bradycardia syndrome and implanted pacemakers. Over a median follow-up of 20.6 months, Cluster 2 had the highest mortality rate (29.1 %), followed by Cluster 3 (20.6 %), compared to Clusters 1 and 4 (11.4 % and 10.8 %, respectively, p = 0.045). For AF events, Cluster 1 had the highest incidence (37 %), followed by Cluster 3 (35 %), Cluster 2 (24 %), and Cluster 4 (19 %, p = 0.309). Heart failure (HR 4.4, CI 1.5–12.7, p = 0.006), cancer (HR 3.3, CI 1.6–6.9, p = 0.002), and severe tricuspid regurgitation (HR 5.4, CI 2.6–11.3, p &lt; 0.001) were predictors of poor outcomes.</div></div><div><h3>Conclusion</h3><div>In severe AtCM patients, four clusters were identified, each with unique comorbidities and mortality rates but similar AF event rates. Clinical and echocardiographic factors were linked to higher mortality risk.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"58 ","pages":"Article 101679"},"PeriodicalIF":2.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143814814","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":"AI-based measurement of cardiothoracic ratio in chest X-rays and prediction of echocardiographic congestive heart failure","authors":"Joshua Ra ,&nbsp;Heejun Shin ,&nbsp;Christopher Park ,&nbsp;Yong-Xiang Wang ,&nbsp;Dongmyung Shin","doi":"10.1016/j.ijcha.2025.101678","DOIUrl":"10.1016/j.ijcha.2025.101678","url":null,"abstract":"<div><h3>Background</h3><div>This study presents an artificial intelligence (AI) model for automated cardiothoracic ratio (CTR) measurement from chest X-rays (CXRs) and evaluates its association with severe left ventricular hypertrophy (SLVH) and dilated left ventricle (DLV) diagnosed by echocardiography. The study also assesses CTR’s prognostic value for predicting future SLVH/DLV development.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, an AI algorithm measured CTR on 71,129 CXRs from 24,673 patients from 2013 to 2018 in the CheXchoNet database. SLVH/DLV was defined using echocardiographic criteria. Diagnostic accuracy was assessed using AUROC and AUPRC alongside sensitivity and specificity at various CTR thresholds. Logistic regression was performed for CXR-echocardiogram pairs. Time-to-event analysis was performed on 9,890 patients without baseline SLVH/DLV.</div></div><div><h3>Results</h3><div>Among 24,673 patients (mean age: 62.1 years; female sex: 56.9 %), mean CTR was higher in SLVH/DLV patients (0.56 ± 0.07) than those without (0.52 ± 0.07; p &lt; 0.001). AUROC was 0.70 (95 % CI: 0.69–0.70). At a CTR threshold of 0.53, sensitivity was 70 % and specificity 60 %. Increased CTR was associated with SLVH/DLV risk on paired echocardiogram, with an odds ratio of 1.26 at a CTR of 0.65 compared to CTR at 0.50 (95 % CI: 1.24–1.27, p &lt; 0.001). Time-to-event analysis on patients without baseline SLVH/DLV showed patients with baseline CTR &gt; 0.65 had a 4.13-fold increased risk of developing SLVH/DLV in the future compared to patients with CTR ≤ 0.50 (adjusted HR: 4.13; 95 % CI: 2.48–6.89; p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>AI-based CTR measurement helps predict SLVH/DLV and could be used for risk stratification for cardiovascular care.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"58 ","pages":"Article 101678"},"PeriodicalIF":2.5,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807512","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 myocardial flow reserve by PET imaging in patients with suspected coronary artery disease: A systematic review and meta-analysis","authors":"Adriana D’Antonio ,&nbsp;Roberta Assante ,&nbsp;Emilia Zampella ,&nbsp;Valeria Cantoni ,&nbsp;Roberta Green ,&nbsp;Valeria Gaudieri ,&nbsp;Teresa Mannarino ,&nbsp;Maria Falzarano ,&nbsp;Federica Volpicelli ,&nbsp;Paolo Cutillo ,&nbsp;Francesca Matrisciano ,&nbsp;Pietro Buongiorno ,&nbsp;Mariarosaria Panico ,&nbsp;Carmela Nappi ,&nbsp;Domenico Cozzolino ,&nbsp;Mario Petretta ,&nbsp;Alberto Cuocolo ,&nbsp;Wanda Acampa","doi":"10.1016/j.ijcha.2025.101677","DOIUrl":"10.1016/j.ijcha.2025.101677","url":null,"abstract":"<div><h3>Purpose</h3><div>We performed a systematic review and <em>meta</em>-analysis of published studies evaluating the value of myocardial flow reserve (MFR) assessed by positron emission tomography (PET) imaging in predicting adverse cardiovascular events in patients with suspected coronary artery disease (CAD).</div></div><div><h3>Material and methods</h3><div>Studies published until December 2024 were identified by database search. We included studies evaluating MFR by PET imaging with data on adjusted hazard ratio (HR) for the occurrence of adverse cardiovascular events.</div></div><div><h3>Results</h3><div>We identified 8 eligible articles including 12.087 patients with a mean follow-up of 2.98 ± 0.69 years. The pooled HR for the occurrence of events was 2.19 (95 % CI 1.80–2.68) and no heterogeneity was observed. The pooled incidence rate ratio (IRR) was 3.26 (95 % CI 2.43–4.37) and the heterogeneity was 37.7 %. At <em>meta</em>-regression analysis no significant association was found between HR for adverse events and demographic and clinical variables considered.</div></div><div><h3>Conclusion</h3><div>MFR assessed by PET imaging is a valuable noninvasive prognostic indicator in the evaluation of patients with suspected CAD.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"58 ","pages":"Article 101677"},"PeriodicalIF":2.5,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143814813","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}