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Fibrinogen-to-albumin ratio as a novel biomarker for risk assessment in clinically suspected acute myocarditis 纤维蛋白原与白蛋白比值作为临床疑似急性心肌炎风险评估的新生物标志物
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-12-01 Epub Date: 2025-09-07 DOI: 10.1016/j.ijcha.2025.101791
Lihi Levi-Gofman , Shaul Atar , Gassan Moady

Background

Acute myocarditis typically follows a benign course, but fatal complications may occur in fulminant cases. Evaluation is based on clinical, laboratory, and imaging parameters. We aimed to assess the prognostic value of the fibrinogen-to-albumin ratio (FAR) in patients with clinically suspected myocarditis.

Methods

Echocardiographic, laboratory, and clinical parameters were obtained from patients with clinically suspected myocarditis. We assessed the correlations between troponin, albumin, fibrinogen, FAR, left ventricular ejection fraction (LVEF), and complications during the index hospitalization. Repeat echocardiography was performed in patients with reduced LVEF. Several potential factors were tested for their ability to predict LVEF recovery.

Results

A total of 118 patients were included (80 % male; median age, 35 years; mean LVEF, 55 %). Median troponin level was 2558 ng/L, and the median fibrinogen-to-albumin ratio (FAR) was 120. In 38 patients (32 %), LVEF was reduced; among them, 15 (39 %) had persistently reduced LVEF on repeat echocardiography. Troponin levels and FAR were inversely correlated with reduced LVEF (r = –0.28, p = 0.002 and r = –0.31, p = 0.001, respectively). FAR remained an independent factor after adjustment for age and sex. Neither troponin nor FAR was associated with persistently reduced LVEF on follow-up echocardiography. In addition, high FAR was not correlated with longer length of stay (LOS) (p = 0.07), readmissions (p = 0.29), or complications during hospitalization (p = 0.22).

Conclusion

FAR is associated with reduced LVEF and may reflect disease severity in clinically suspected myocarditis; however, it does not appear to be useful for long-term prediction.
背景:急性心肌炎通常是良性的,但暴发性病例可能出现致命的并发症。评估基于临床、实验室和影像学参数。我们的目的是评估纤维蛋白原与白蛋白比(FAR)在临床疑似心肌炎患者中的预后价值。方法收集临床疑似心肌炎患者的心电图、实验室及临床资料。我们评估了肌钙蛋白、白蛋白、纤维蛋白原、FAR、左心室射血分数(LVEF)与住院期间并发症的相关性。对LVEF降低的患者进行重复超声心动图检查。测试了几个潜在因素预测LVEF恢复的能力。结果共纳入118例患者,其中男性80%,中位年龄35岁,平均LVEF 55%。肌钙蛋白水平中位数为2558 ng/L,纤维蛋白原/白蛋白比中位数为120。38例(32%)患者LVEF降低;其中15例(39%)重复超声心动图显示LVEF持续降低。肌钙蛋白水平和FAR与LVEF降低呈负相关(r = -0.28, p = 0.002和r = -0.31, p = 0.001)。在调整了年龄和性别后,FAR仍然是一个独立的因素。随访超声心动图显示,肌钙蛋白和FAR均与LVEF持续降低无关。此外,高FAR与较长的住院时间(LOS) (p = 0.07)、再入院(p = 0.29)或住院期间的并发症(p = 0.22)无关。结论far与LVEF降低相关,可反映临床疑似心肌炎患者病情严重程度;然而,它似乎对长期预测并不有用。
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引用次数: 0
Use of the novel virtual myectomy in guiding thoracoscopic myectomy for patients with hypertrophic obstructive cardiomyopathy 应用新型虚拟肌瘤切除术指导胸腔镜下肥厚性梗阻性心肌病患者的肌瘤切除术
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-12-01 Epub Date: 2025-09-23 DOI: 10.1016/j.ijcha.2025.101795
Peijian Wei , Tong Tan , Shengwen Wang , Jiexu Ma , Guanyu Lu , Haozhong Liu , Hanxiang Xie , Wei Zhu , Jian Zhuang , Jian Liu , Huiming Guo

Background

This study aimed to evaluate the efficacy of a novel virtual myectomy procedure in guiding thoracoscopic trans-mitral myectomy.

Methods and Results

Clinical data from 37 patients who underwent thoracoscopic trans-mitral septal myectomy guided by virtual myectomy between April 2019 and October 2021 were retrospectively analyzed. Enhanced cardiac CT images were imported into Mimics software to perform virtual myectomy. The short-axis two-chamber plane, perpendicular to the interventricular septum (IVS), was marked for each segment from the basal septum to the apex. IVS thickness was continuously measured at each marked segment, and a figurative digital model determined the resection extent. The cohort consisted of 22 women (59.46 %) with a mean age of 53.14 ± 13.62 years. No deaths or permanent pacemaker implantations occurred. Septal thickness decreased significantly from 20.49 ± 3.85 to 11.28 ± 2.53 mm (P < 0.001), resulting in a marked reduction in obstruction (90.84 ± 28.78 to 11.59 ± 11.06 mmHg, P < 0.001). Twelve patients (32.43 %) underwent mitral valve replacement. The virtual resection’s length, width, thickness, and volume showed strong positive correlations with the actual resection (R = 0.76–0.89). The virtual model’s septal thickness was moderately correlated with the actual resection volume (R = 0.51, P < 0.01).

Conclusions

Virtual myectomy effectively guided septal myectomy, with favorable outcomes in selected patients. This approach, combined with preoperative 3D simulation and printing, enables precise planning for complex cases.
背景:本研究旨在评估一种新型虚拟肌瘤切除术在指导胸腔镜经二尖瓣肌瘤切除术中的效果。方法和结果回顾性分析2019年4月至2021年10月37例胸腔镜下经二尖瓣间隔肌切除术引导下虚拟肌切除术患者的临床资料。将增强心脏CT图像导入Mimics软件进行虚拟肌瘤切除术。垂直于室间隔(IVS)的短轴双室平面,标记了从室间隔基部到鼻尖的每段。连续测量每个标记段的IVS厚度,并通过图形化的数字模型确定切除程度。该队列包括22名女性(59.46%),平均年龄为53.14±13.62岁。没有发生死亡或永久性心脏起搏器植入。鼻中隔厚度由20.49±3.85 mm降至11.28±2.53 mm (P < 0.001),导致阻塞明显减少(90.84±28.78降至11.59±11.06 mmHg, P < 0.001)。12例(32.43%)行二尖瓣置换术。虚拟切除的长度、宽度、厚度和体积与实际切除呈强正相关(R = 0.76-0.89)。虚拟模型的间隔厚度与实际切除体积有中度相关性(R = 0.51, P < 0.01)。结论虚拟肌瘤切除术能有效指导中隔肌瘤切除术,对部分患者疗效良好。这种方法与术前3D模拟和打印相结合,可以对复杂病例进行精确规划。
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引用次数: 0
Mental stress is associated with coronary endothelial dysfunction in women with chest pain and non-obstructive coronary artery disease 精神压力与胸痛和非阻塞性冠状动脉疾病女性冠状动脉内皮功能障碍相关
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-12-01 Epub Date: 2025-09-22 DOI: 10.1016/j.ijcha.2025.101802
Jaskanwal Deep S Sara , Nazanin Rajai , Scott Breitinger , Betsy Medina-Inojosa , Lilach O Lerman , Amir Lerman

Objective

We evaluate the association between chronic mental stress (MS) and coronary endothelial function in patients with chest pain and nonobstructive coronary artery disease (CAD) separately in males and females.

Methods

Patients with nonobstructive CAD (stenosis <40 %) at coronary angiography underwent an invasive assessment for coronary endothelial dysfunction (CED). Macrovascular CED was defined as a percentage change in coronary artery diameter to acetylcholine (%ΔCADAch) ≤ −10 % and microvascular CED was defined as a percentage change in coronary blood flow to acetylcholine (%ΔCBFAch) ≤−50 %. Patients completed a questionnaire within 2 years of the index procedure that included questions regarding chronic MS. The frequency of macrovascular, microvascular and any type of CED was compared across groups. Logistic regression analyses were performed to assess the association between MS and CED.

Results

Between January 2017 and December 2022, 211 patients (mean (sd) age 54.4 (13.6) yrs, 71.0 % female) were included. One hundred forty-two (67.3 %) patients had any type of CED. In females with significant MS there was a higher proportion of individuals with any type of CED compared to without CED (43 (42.6 %) vs. 12 (24.5 %), p = 0.0362). In a multivariable analysis MS was associated with any type of CED in females: OR (95 % CI) 2.70 (1.24–6.25); p = 0.0156.

Conclusion

Chronic MS is associated with CED in females with chest pain and nonobstructive CAD. Chronic MS may underly the mechanism for chest pain in these patients and may play a contributory to cardiovascular disease through its association with endothelial dysfunction.
目的探讨胸痛和非阻塞性冠状动脉疾病(CAD)患者慢性精神应激(MS)与冠状动脉内皮功能的关系。方法非阻塞性CAD(狭窄<; 40%)患者在冠状动脉造影时接受冠状动脉内皮功能障碍(CED)的侵入性评估。大血管CED定义为冠状动脉直径对乙酰胆碱的百分比变化(%ΔCADAch)≤- 10%,微血管CED定义为冠状动脉血流量对乙酰胆碱的百分比变化(%ΔCBFAch)≤- 50%。患者在指标手术后2年内完成一份问卷,其中包括关于慢性ms的问题,比较各组大血管、微血管和任何类型CED的频率。采用Logistic回归分析来评估多发性硬化症与CED之间的关系。结果2017年1月至2022年12月,纳入211例患者(平均(sd)年龄54.4(13.6)岁,女性71.0%)。142例(67.3%)患者有任何类型的CED。在有明显多发性硬化症的女性中,有任何类型的CED的个体比例高于没有CED的个体(43人(42.6%)比12人(24.5%),p = 0.0362)。在多变量分析中,MS与女性任何类型的CED相关:OR (95% CI) 2.70 (1.24-6.25);p = 0.0156。结论女性胸痛合并非阻塞性CAD患者慢性MS与CED相关。慢性多发性硬化症可能是这些患者胸痛的潜在机制,并可能通过与内皮功能障碍相关而导致心血管疾病。
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引用次数: 0
Sex-related differences in myocardial fibrosis among patients with aortic stenosis: A systematic review and meta-analysis 主动脉瓣狭窄患者心肌纤维化的性别差异:一项系统回顾和荟萃分析
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-12-01 Epub Date: 2025-09-30 DOI: 10.1016/j.ijcha.2025.101814
Paul C. Onyeji , Shivank Dani , Sonise Momplaisir-Onyeji , Miguel C. Lenzi , Paweł Łajczak , Felipe S. Passos , Leo Consoli , Hristo Kirov , Torsten Doenst , Tulio Caldonazo

Background

Aortic stenosis (AS) leads to pathological myocardial remodeling, particularly fibrosis, which contributes to adverse outcomes including heart failure, arrhythmias, and mortality. Evidence suggests sex-specific differences in fibrotic response, but individual studies are underpowered for definitive conclusions. This meta-analysis aimed to evaluate sex-related differences in myocardial fibrosis using cardiac magnetic resonance (CMR) parameters.

Methods

Three databases were searched for studies comparing male and female patients with AS reporting CMR-derived measures. The primary outcomes were late gadolinium enhancement (LGE%), infarct-related and non-infarct-related LGE, extracellular volume (ECV) and Septal E/e′. Effect sizes were expressed as risk ratios (RR) for binary outcomes and mean differences (MD) for continuous outcomes, each with 95% confidence intervals (CI), using random-effects models. Study quality was appraised with the Newcastle–Ottawa Scale, and certainty of evidence was graded using the GRADE framework.

Results

Seven studies (n = 2,105; 1,246 males) were included. No significant difference was observed in LGE% (MD 0.13; 95 %CI −0.93 to 1.18; p = 0.770), and risks of infarct-related LGE between sexes (RR 1.61; 95 %CI 0.90 to 2.89; p = 0.080). Males had higher risk of non-infarct LGE (RR 1.51; 95 %CI 1.34 to 1.70; p = 0.002). There were no significant differences in ECV (MD −0.45; 95 %CI −2.34 to 1.44; p = 0.506) and Septal E/e′ between sexes (MD −1.87; 95 %CI −4.05 to 0.32; p = 0.072).

Conclusion

This meta-analysis shows sex-related differences in myocardial fibrosis in AS, with men exhibiting more focal replacement fibrosis and women a tendency toward diffuse interstitial fibrosis. These patterns highlight the relevance of incorporating sex-specific factors into diagnosis and management.
主动脉狭窄(AS)导致病理性心肌重构,尤其是纤维化,导致心衰、心律失常和死亡等不良后果。证据表明,纤维化反应存在性别特异性差异,但个体研究不足以得出明确结论。本荟萃分析旨在利用心脏磁共振(CMR)参数评估心肌纤维化的性别相关差异。方法检索三个数据库,比较报告cmr衍生测量的男性和女性AS患者的研究。主要结局是晚期钆增强(LGE%)、梗死相关和非梗死相关LGE、细胞外体积(ECV)和间隔E/ E’。使用随机效应模型,用二元结果的风险比(RR)和连续结果的平均差异(MD)表示效应量,每个结果都有95%的置信区间(CI)。使用纽卡斯尔-渥太华量表评估研究质量,并使用GRADE框架对证据的确定性进行评分。结果纳入7项研究(n = 2105,男性1246)。LGE% (MD = 0.13; 95% CI = - 0.93 ~ 1.18; p = 0.770)和梗死相关LGE的风险在两性间无显著差异(RR = 1.61; 95% CI = 0.90 ~ 2.89; p = 0.080)。男性发生非梗死性LGE的风险较高(RR 1.51; 95% CI 1.34 ~ 1.70; p = 0.002)。两性间ECV (MD - 0.45, 95% CI - 2.34 ~ 1.44, p = 0.506)和鼻中隔E/ E′无显著差异(MD - 1.87, 95% CI - 4.05 ~ 0.32, p = 0.072)。这项荟萃分析显示了AS患者心肌纤维化的性别差异,男性表现出更多的局灶性替代纤维化,而女性倾向于弥漫性间质纤维化。这些模式突出了将性别特异性因素纳入诊断和管理的相关性。
{"title":"Sex-related differences in myocardial fibrosis among patients with aortic stenosis: A systematic review and meta-analysis","authors":"Paul C. Onyeji ,&nbsp;Shivank Dani ,&nbsp;Sonise Momplaisir-Onyeji ,&nbsp;Miguel C. Lenzi ,&nbsp;Paweł Łajczak ,&nbsp;Felipe S. Passos ,&nbsp;Leo Consoli ,&nbsp;Hristo Kirov ,&nbsp;Torsten Doenst ,&nbsp;Tulio Caldonazo","doi":"10.1016/j.ijcha.2025.101814","DOIUrl":"10.1016/j.ijcha.2025.101814","url":null,"abstract":"<div><h3>Background</h3><div>Aortic stenosis (AS) leads to pathological myocardial remodeling, particularly fibrosis, which contributes to adverse outcomes including heart failure, arrhythmias, and mortality. Evidence suggests sex-specific differences in fibrotic response, but individual studies are underpowered for definitive conclusions. This <em>meta</em>-analysis aimed to evaluate sex-related differences in myocardial fibrosis using cardiac magnetic resonance (CMR) parameters.</div></div><div><h3>Methods</h3><div>Three databases were searched for studies comparing male and female patients with AS reporting CMR-derived measures. The primary outcomes were late gadolinium enhancement (LGE%), infarct-related and non-infarct-related LGE, extracellular volume (ECV) and Septal E/e′. Effect sizes were expressed as risk ratios (RR) for binary outcomes and mean differences (MD) for continuous outcomes, each with 95% confidence intervals (CI), using random-effects models. Study quality was appraised with the Newcastle–Ottawa Scale, and certainty of evidence was graded using the GRADE framework.</div></div><div><h3>Results</h3><div>Seven studies (n = 2,105; 1,246 males) were included. No significant difference was observed in LGE% (MD 0.13; 95 %CI −0.93 to 1.18; p = 0.770), and risks of infarct-related LGE between sexes (RR 1.61; 95 %CI 0.90 to 2.89; p = 0.080). Males had higher risk of non-infarct LGE (RR 1.51; 95 %CI 1.34 to 1.70; p = 0.002). There were no significant differences in ECV (MD −0.45; 95 %CI −2.34 to 1.44; p = 0.506) and Septal E/e′ between sexes (MD −1.87; 95 %CI −4.05 to 0.32; p = 0.072).</div></div><div><h3>Conclusion</h3><div>This <em>meta</em>-analysis shows sex-related differences in myocardial fibrosis in AS, with men exhibiting more focal replacement fibrosis and women a tendency toward diffuse interstitial fibrosis. These patterns highlight the relevance of incorporating sex-specific factors into diagnosis and management.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101814"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220595","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
High-sensitivity C-reactive protein is associated with altered cardiac structure and function in psoriasis: The PSOCADIA study 高敏c反应蛋白与银屑病患者心脏结构和功能改变有关:PSOCADIA研究
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-12-01 Epub Date: 2025-11-03 DOI: 10.1016/j.ijcha.2025.101832
Maria Dons , Morten Sengeløv , Kristoffer Grundtvig Skaarup , Niklas Dyrby Johansen , Mats C.H. Lassen , Sofie Bøgh-Sørensen , Julie I.H. Borchsenius , Filip Soeskov Davidovski , Nino E. Landler , Christoffer V. Nissen , Peter Riis Hansen , Brittany N. Weber , Claus Zachariae , Lone Skov , Tor Biering-Sørensen

Background

High sensitivity C-reactive protein (hsCRP) is a biomarker of systemic inflammation that may be associated with cardiovascular risk in psoriasis. We assessed the relationship between hsCRP levels and cardiac structure and function in a large cross-sectional cohort study of individuals with psoriasis.

Methods

Adults with psoriasis underwent hsCRP testing and transthoracic echocardiography. Myocardial dysfunction was defined as left ventricular ejection fraction < 50 % and/or global longitudinal strain (GLS) < 16 %. Diastolic dysfunction followed standard echocardiographic guidelines. Associations between hsCRP tertiles, cardiometabolic risk factors, and cardiac structure and function were evaluated. Logistic regression assessed odds of myocardial dysfunction with hsCRP > 2 mg/L.

Results

972 adults with psoriasis were prospectively included (median age 54 years, 44.9 % women, 75.2 % moderate-to-severe psoriasis). Median hsCRP was 1.14 mg/L. Lower hsCRP levels were linked to greater biologic therapy use. Higher hsCRP was associated with older age, female sex, increased body mass index, and greater cardiometabolic risk factor burden.
The highest hsCRP tertile had greater rates of myocardial dysfunction (28.8 %) and diastolic dysfunction (31.3 %) compared to the lowest tertile (17.6 % and 21.8 %, respectively, p < 0.05 for both). After multivariable adjustment, increasing hsCRP was associated with impaired GLS and LVEF, and an hsCRP > 2 mg/L was independently associated with a 45 % increased odds of myocardial dysfunction (OR 1.45, 95 % CI: 1.02 – 2.07, p = 0.042).

Conclusions

In psoriasis, elevated hsCRP was independently associated with impaired systolic function, reflected by reduced GLS and LVEF. These findings suggest systemic inflammation may be involved in early myocardial dysfunction in this population.
背景:高灵敏度c反应蛋白(hsCRP)是全身性炎症的生物标志物,可能与银屑病的心血管风险相关。我们在一项针对牛皮癣患者的大型横断面队列研究中评估了hsCRP水平与心脏结构和功能之间的关系。方法对成人银屑病患者行hsCRP检测和经胸超声心动图检查。心肌功能障碍定义为左心室射血分数(llt; 50%)和/或整体纵向应变(GLS) (llt; 16%)。舒张功能不全符合超声心动图标准。评估hsCRP类型、心脏代谢危险因素和心脏结构和功能之间的关系。Logistic回归评估2 mg/L hsCRP引起心肌功能障碍的几率。结果前瞻性纳入972例成人牛皮癣患者(中位年龄54岁,44.9%为女性,75.2%为中度至重度牛皮癣)。中位hsCRP为1.14 mg/L。较低的hsCRP水平与更多的生物治疗使用有关。较高的hsCRP与年龄较大、女性、体重指数增加和更大的心脏代谢危险因素负担相关。高hsCRP组的心肌功能障碍发生率(28.8%)和舒张功能障碍发生率(31.3%)高于低hsCRP组(分别为17.6%和21.8%,p < 0.05)。多变量调整后,hsCRP升高与GLS和LVEF受损相关,2 mg/L hsCRP与心肌功能障碍发生率增加45%独立相关(OR 1.45, 95% CI: 1.02 - 2.07, p = 0.042)。结论银屑病患者hsCRP升高与收缩功能受损独立相关,表现为GLS和LVEF降低。这些发现提示全身性炎症可能与该人群早期心肌功能障碍有关。
{"title":"High-sensitivity C-reactive protein is associated with altered cardiac structure and function in psoriasis: The PSOCADIA study","authors":"Maria Dons ,&nbsp;Morten Sengeløv ,&nbsp;Kristoffer Grundtvig Skaarup ,&nbsp;Niklas Dyrby Johansen ,&nbsp;Mats C.H. Lassen ,&nbsp;Sofie Bøgh-Sørensen ,&nbsp;Julie I.H. Borchsenius ,&nbsp;Filip Soeskov Davidovski ,&nbsp;Nino E. Landler ,&nbsp;Christoffer V. Nissen ,&nbsp;Peter Riis Hansen ,&nbsp;Brittany N. Weber ,&nbsp;Claus Zachariae ,&nbsp;Lone Skov ,&nbsp;Tor Biering-Sørensen","doi":"10.1016/j.ijcha.2025.101832","DOIUrl":"10.1016/j.ijcha.2025.101832","url":null,"abstract":"<div><h3>Background</h3><div>High sensitivity C-reactive protein (hsCRP) is a biomarker of systemic inflammation that may be associated with cardiovascular risk in psoriasis. We assessed the relationship between hsCRP levels and cardiac structure and function in a large cross-sectional cohort study of individuals with psoriasis.</div></div><div><h3>Methods</h3><div>Adults with psoriasis underwent hsCRP testing and transthoracic echocardiography. Myocardial dysfunction was defined as left ventricular ejection fraction &lt; 50 % and/or global longitudinal strain (GLS) &lt; 16 %. Diastolic dysfunction followed standard echocardiographic guidelines. Associations between hsCRP tertiles, cardiometabolic risk factors, and cardiac structure and function were evaluated. Logistic regression assessed odds of myocardial dysfunction with hsCRP &gt; 2 mg/L.</div></div><div><h3>Results</h3><div>972 adults with psoriasis were prospectively included (median age 54 years, 44.9 % women, 75.2 % moderate-to-severe psoriasis). Median hsCRP was 1.14 mg/L. Lower hsCRP levels were linked to greater biologic therapy use. Higher hsCRP was associated with older age, female sex, increased body mass index, and greater cardiometabolic risk factor burden.</div><div>The highest hsCRP tertile had greater rates of myocardial dysfunction (28.8 %) and diastolic dysfunction (31.3 %) compared to the lowest tertile (17.6 % and 21.8 %, respectively, p &lt; 0.05 for both). After multivariable adjustment, increasing hsCRP was associated with impaired GLS and LVEF, and an hsCRP &gt; 2 mg/L was independently associated with a 45 % increased odds of myocardial dysfunction (OR 1.45, 95 % CI: 1.02 – 2.07, p = 0.042).</div></div><div><h3>Conclusions</h3><div>In psoriasis, elevated hsCRP was independently associated with impaired systolic function, reflected by reduced GLS and LVEF. These findings suggest systemic inflammation may be involved in early myocardial dysfunction in this population.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101832"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465379","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
Association of complete revascularization with safety and outcomes in elderly patients with multi-vessel coronary artery disease: a systematic review and meta-analysis 老年多支冠状动脉疾病患者完全血运重建术与安全性和预后的关系:一项系统综述和荟萃分析
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-12-01 Epub Date: 2025-10-21 DOI: 10.1016/j.ijcha.2025.101825
David T. Zhang , Matt Raven , Manasa Dondapati , Ravi Masson , Puja B. Parikh , Travis Bench , John P. Reilly , Michael Tao

Background

The utility of complete revascularization has been well defined in young patients with acute coronary syndrome (ACS) and multivessel coronary artery disease (CAD). However, the clinical benefit in elderly patients remains unclear with current literature has yielded conflicting results. This meta-analysis aims to evaluate the association of complete versus culprit-only coronary revascularization with mortality in elderly patients with multivessel CAD.

Methods

A literature search was conducted for studies reporting on outcomes after complete versus culprit-only revascularization in elderly patients with multivessel CAD presenting with ACS. The primary endpoint was all-cause mortality. The main secondary endpoint was cardiovascular (CV) mortality. The search included the following databases: PubMed, EMBASE, and Web of Science. The search was not restricted to time or publication status.

Results

14 studies with 11,994 elderly patients (7,236 with culprit-only, 4,758 with complete revascularization) met inclusion criteria. Mean follow-up duration was 29.0 months (range 12–56 months), mean age was 79.5 years old, 56.9% of patients were men, and mean left ventricular ejection fraction was 54.3%. Patients who underwent complete revascularization had significantly lower all-cause and CV mortality compared to culprit-only revascularization (OR 1.75, 95% CI 1.40–2.18; p < 0.001; OR 1.75, 95% CI 1.14–2.68; p = 0.01). Subgroup analysis demonstrated this association to be statistically significant for studies with cohorts presenting with non-ST segment elevation myocardial infarction (NSTEMI) and mixed cohorts that included NSTEMI and ST segment elevation myocardial infarction (STEMI) patients. However, there was no significant difference in risk of all-cause mortality with complete versus culprit-only revascularization in studies of only STEMI patients (OR 1.03, 95% CI 0.61–1.72; p = 0.92).

Conclusion

Complete coronary revascularization is associated with lower risk of all-cause and CV mortality in elderly patients with multivessel CAD presenting with NSTEMI. However, there does not appear to be a difference in outcomes in patients presenting with STEMI.
背景:完全血运重建术在年轻急性冠状动脉综合征(ACS)和多支冠状动脉疾病(CAD)患者中的应用已经得到了明确的定义。然而,老年患者的临床获益尚不清楚,目前的文献得出了相互矛盾的结果。本荟萃分析旨在评估老年多血管冠心病患者完全冠脉重建术与单纯冠脉重建术与死亡率的关系。方法对伴有ACS的老年多血管CAD患者行完全血管重建术与仅行罪魁祸首血管重建术的结果进行文献检索。主要终点是全因死亡率。主要的次要终点是心血管(CV)死亡率。搜索包括以下数据库:PubMed, EMBASE和Web of Science。搜索不限于时间或出版状态。结果14项研究纳入11,994例老年患者(仅罪魁祸首7236例,完全血运重建4758例)。平均随访时间29.0个月(12-56个月),平均年龄79.5岁,男性56.9%,平均左室射血分数54.3%。完全血运重建术患者的全因死亡率和CV死亡率明显低于单纯的罪魁祸首血运重建术患者(OR 1.75, 95% CI 1.40-2.18; p < 0.001; OR 1.75, 95% CI 1.14-2.68; p = 0.01)。亚组分析表明,在以非ST段抬高型心肌梗死(NSTEMI)为研究对象的队列和包括NSTEMI和ST段抬高型心肌梗死(STEMI)患者的混合队列中,这种关联具有统计学意义。然而,在仅STEMI患者的研究中,完全血运重建与仅罪魁祸首血运重建的全因死亡率风险无显著差异(OR 1.03, 95% CI 0.61-1.72; p = 0.92)。结论完全冠状动脉血运重建术与老年多血管冠心病合并NSTEMI患者全因死亡率和CV死亡率降低相关。然而,STEMI患者的预后似乎没有差异。
{"title":"Association of complete revascularization with safety and outcomes in elderly patients with multi-vessel coronary artery disease: a systematic review and meta-analysis","authors":"David T. Zhang ,&nbsp;Matt Raven ,&nbsp;Manasa Dondapati ,&nbsp;Ravi Masson ,&nbsp;Puja B. Parikh ,&nbsp;Travis Bench ,&nbsp;John P. Reilly ,&nbsp;Michael Tao","doi":"10.1016/j.ijcha.2025.101825","DOIUrl":"10.1016/j.ijcha.2025.101825","url":null,"abstract":"<div><h3>Background</h3><div>The utility of complete revascularization has been well defined in young patients with acute coronary syndrome (ACS) and multivessel coronary artery disease (CAD). However, the clinical benefit in elderly patients remains unclear with current literature has yielded conflicting results. This meta-analysis aims to evaluate the association of complete versus culprit-only coronary revascularization with mortality in elderly patients with multivessel CAD.</div></div><div><h3>Methods</h3><div>A literature search was conducted for studies reporting on outcomes after complete versus culprit-only revascularization in elderly patients with multivessel CAD presenting with ACS. The primary endpoint was all-cause mortality. The main secondary endpoint was cardiovascular (CV) mortality. The search included the following databases: PubMed, EMBASE, and Web of Science. The search was not restricted to time or publication status.</div></div><div><h3>Results</h3><div>14 studies with 11,994 elderly patients (7,236 with culprit-only, 4,758 with complete revascularization) met inclusion criteria. Mean follow-up duration was 29.0 months (range 12–56 months), mean age was 79.5 years old, 56.9% of patients were men, and mean left ventricular ejection fraction was 54.3%. Patients who underwent complete revascularization had significantly lower all-cause and CV mortality compared to culprit-only revascularization (OR 1.75, 95% CI 1.40–2.18; p &lt; 0.001; OR 1.75, 95% CI 1.14–2.68; p = 0.01). Subgroup analysis demonstrated this association to be statistically significant for studies with cohorts presenting with non-ST segment elevation myocardial infarction (NSTEMI) and mixed cohorts that included NSTEMI and ST segment elevation myocardial infarction (STEMI) patients. However, there was no significant difference in risk of all-cause mortality with complete versus culprit-only revascularization in studies of only STEMI patients (OR 1.03, 95% CI 0.61–1.72; p = 0.92).</div></div><div><h3>Conclusion</h3><div>Complete coronary revascularization is associated with lower risk of all-cause and CV mortality in elderly patients with multivessel CAD presenting with NSTEMI. However, there does not appear to be a difference in outcomes in patients presenting with STEMI.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101825"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145362285","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
Evaluating artificial intelligence-enabled medical tests in cardiology: Best practice 评估心脏病学中启用人工智能的医学测试:最佳实践
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-10-01 Epub Date: 2025-08-30 DOI: 10.1016/j.ijcha.2025.101783
Jonas L. Isaksen , Malene Nørregaard , Martin Manninger , Dobromir Dobrev , Thomas Jespersen , Ben Hermans , Jordi Heijman , Gernot Plank , Daniel Scherr , Thomas Pock , Vajira Thambawita , Michael A. Riegler , Jørgen K. Kanters , Dominik Linz
Machine learning methods are increasingly used in cardiovascular research. In order to highlight opportunities and challenges of the evaluation of studies applying machine learning, we use examples from cardiac electrophysiology, a field characterized by large and often imbalanced amounts of data. We provide recommendations and guidance on evaluating and presenting supervised machine learning studies. We recommend proper cohort selection, keeping training and testing data strictly separate, and comparing results to a reference model without machine learning as basic principles to ensure the quality of studies using machine learning methods. We furthermore recommend specific metrics and plots when reporting on machine learning including on models for multi-channel time series or images. This Best Practice paper represents a possible blueprint to help evaluate machine learning-based medical tests in cardiac electrophysiology and beyond.
机器学习方法越来越多地应用于心血管研究。为了强调应用机器学习评估研究的机遇和挑战,我们使用了心脏电生理学的例子,这是一个以大量且经常不平衡的数据为特征的领域。我们为评估和展示监督机器学习研究提供建议和指导。我们建议适当的队列选择,将训练和测试数据严格分开,并将结果与没有机器学习的参考模型进行比较作为基本原则,以确保使用机器学习方法的研究质量。在报告机器学习时,我们进一步推荐具体的指标和图表,包括多通道时间序列或图像的模型。这篇最佳实践论文代表了一个可能的蓝图,可以帮助评估心脏电生理学等领域基于机器学习的医学测试。
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引用次数: 0
Recent highlights from the International Journal of Cardiology Heart and Vasculature: cardio-oncology 《国际心脏病学杂志:心脏与脉管系统:心脏肿瘤学》的最新亮点
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-10-01 Epub Date: 2025-08-27 DOI: 10.1016/j.ijcha.2025.101780
Anke Fender , Florian Bruns , Dobromir Dobrev
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引用次数: 0
Comparison of clinical outcomes between catheter ablation and permanent pacemaker implantation in Tachycardia-Bradycardia Syndrome patients: a meta-analysis 心动过速-心动过缓综合征患者导管消融与永久性起搏器植入的临床结果比较:一项meta分析
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-10-01 Epub Date: 2025-08-11 DOI: 10.1016/j.ijcha.2025.101767
Sunu Budhi Raharjo , Emir Yonas , Sarah Naura Irbah , Dicky Armein Hanafy , Muhammad Rizky Felani , Aldo Ferly , Fa Po Chung

Introduction

Tachycardia-Bradycardia Syndrome (TBS) is a clinical disorder resulting from complications associated with sick sinus syndrome (SSS). In patients with SSS, TBS is marked by alternating episodes of tachycardia and bradycardia. This meta-analysis aims to evaluate and compare the differences in clinical outcomes between ablation and pacemaker treatments for TBS.

Methods

We performed a systematic search on libraries, including PubMed, EuropePMC, SCOPUS, Cochrane Central, and medRxiv, for preprint studies. The search terms used were “Tachycardia Bradycardia Syndrome,” “Pacing,” and “Ablation” between the pacing and ablation groups in TBS patients. Review Manager Software Version 5.4 (Cochrane Collaboration) was used to perform the meta-analysis.

Results

We identified 1,138 potential articles from our search, and 521 duplicates were removed. After screening the titles and abstracts of the remaining 662 articles, we obtained 23 potentially relevant articles. Finally, we included the remaining eight studies in our qualitative synthesis and meta-analysis, which comprised 1,266 patients.
Catheter ablation was associated with a lower incidence of AF recurrence (OR of 0.09 [0.04, 0.22; p < 0.001], with moderate heterogeneity (I2 = 76 %, p < 0.001), stroke (OR of 0.28 [0.14, 0.53; p < 0.001] low heterogeneity I2 = 0 %, p = 0.99 favouring the ablation group.) and lower mortality (OR of 0.37 [0.17, 0.80; p0.01] low heterogeneity I2 = 0 %, p = 0.84 favouring the ablation group), compared to those who underwent pacemaker implantation in patients with TBS.

Conclusion

Catheter ablation resulted in a lower incidence of AF recurrence, stroke, and mortality compared to the pacemaker in TBS patients. There was no difference between groups regarding procedure-related complications and cardiovascular rehospitalization.
心动过速-心动过缓综合征(TBS)是一种由病窦综合征(SSS)相关并发症引起的临床疾病。在SSS患者中,TBS以心动过速和心动过缓交替发作为特征。本荟萃分析旨在评估和比较消融和起搏器治疗TBS的临床结果差异。方法系统检索PubMed、EuropePMC、SCOPUS、Cochrane Central和medRxiv等图书馆的预印本研究。TBS患者起搏组和消融组之间的搜索词为“心动过速-心动过缓综合征”、“起搏”和“消融”。采用Review Manager Software Version 5.4 (Cochrane Collaboration)进行meta分析。结果我们从搜索中确定了1138篇潜在的文章,521篇重复的文章被删除。在筛选剩下的662篇文章的标题和摘要后,我们获得了23篇可能相关的文章。最后,我们将其余8项研究纳入定性综合和荟萃分析,共1266例患者。导管消融与房颤复发率较低相关(OR = 0.09 [0.04, 0.22;p & lt;0.001],具有中等异质性(I2 = 76%, p <;0.001)、中风(OR为0.28 [0.14,0.53;p & lt;低异质性I2 = 0%, p = 0.99,有利于消融组)和较低的死亡率(OR为0.37 [0.17,0.80;[p0.01]低异质性I2 = 0%, p = 0.84有利于消融组),与接受起搏器植入的TBS患者相比。结论与起搏器相比,导管消融导致房颤复发、卒中和死亡率降低。在手术相关并发症和心血管再住院方面,两组间无差异。
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引用次数: 0
Artificial-intelligence-assisted CCTA quantifies sex differences in coronary atherosclerotic burden at low atheroma volumes 人工智能辅助CCTA量化低动脉粥样硬化体积下冠状动脉粥样硬化负荷的性别差异
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-10-01 Epub Date: 2025-07-28 DOI: 10.1016/j.ijcha.2025.101758
Zoee D’Costa , Ronald P. Karlsberg , Geoffrey W. Cho

Background

Coronary artery disease (CAD) manifests differently between sexes, with data suggesting females develop more non-calcified plaques that traditional calcium-centric tools may not detect.

Methods

We conducted a retrospective cohort study of 100 individuals with low total atheroma volume (TAV) < 250 mm3 using artificial intelligence (AI)-enabled coronary computed tomography angiography (CCTA) to assess sex-based differences in coronary plaque composition. Plaque subtypes included calcified, non-calcified, and low-density non-calcified atheroma volumes.

Results

Females had significantly lower total (p = 0.018) and non-calcified plaque (p < 0.001) burden compared to males. Calcified (p = 0.52) and low-density non-calcified (p = 0.16) plaque volumes did not differ significantly. Age was a consistent predictor of plaque volume across most subtypes.

Conclusions

Despite low overall plaque burden, males demonstrated a higher non-calcified plaque burden than females. This finding contrasts with previous literature and underscores the potential of AI-enabled CCTA to detect subclinical coronary disease, particularly in low-risk cohorts. These results support the use of comprehensive plaque profiling in both sexes to improve early risk stratification.
背景:冠状动脉疾病(CAD)在性别之间表现不同,数据表明女性发展出更多的非钙化斑块,而传统的以钙为中心的工具可能无法检测到。方法:我们对100例低总动脉粥样硬化体积(TAV)和lt患者进行了回顾性队列研究;使用人工智能(AI)支持的冠状动脉计算机断层血管造影(CCTA)评估冠状动脉斑块组成的性别差异。斑块亚型包括钙化、非钙化和低密度非钙化斑块。结果女性患者总斑块数(p = 0.018)和非钙化斑块数(p <;0.001),与男性相比。钙化斑块(p = 0.52)和低密度非钙化斑块(p = 0.16)的体积没有显著差异。年龄是大多数亚型斑块体积的一致预测因子。结论:尽管总体斑块负担较低,但男性的非钙化斑块负担高于女性。这一发现与以前的文献形成对比,强调了人工智能支持的CCTA检测亚临床冠状动脉疾病的潜力,特别是在低风险人群中。这些结果支持在两性中使用全面的斑块分析来改善早期风险分层。
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引用次数: 0
期刊
IJC Heart and Vasculature
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