Pub Date : 2026-01-06DOI: 10.1016/j.ijcha.2025.101855
Ayman Jubran , Raumil V Patel , Denis Qeska , Ragavie Manoragavan , Issac Yang , Anastasia Oikonomou , Harindra C Wijeysundera
{"title":"The role of membranous septum length as a predictor for post-TAVR pacemaker implantation in patients with pre-existing RBBB","authors":"Ayman Jubran , Raumil V Patel , Denis Qeska , Ragavie Manoragavan , Issac Yang , Anastasia Oikonomou , Harindra C Wijeysundera","doi":"10.1016/j.ijcha.2025.101855","DOIUrl":"10.1016/j.ijcha.2025.101855","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101855"},"PeriodicalIF":2.5,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924279","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}
Pub Date : 2026-01-06DOI: 10.1016/j.ijcha.2025.101865
Naomi E. Wattchow , Thalia Salagaras , Mau T. Nguyen , Lauren Y.J. Sandeman , Gemma A. Figtree , Giuseppe Di Giovanni , Dennis T.L. Wong , Stephen J. Nicholls , Christina A. Bursill , Peter J. Psaltis
Background
Syndecan-1 and endocan are biomarkers of endothelial damage, which associate with worse outcomes after myocardial infarction (MI). As it is unclear how this is mediated, we investigated how they associate with the composition of residual, non-culprit coronary atherosclerotic plaques following acute MI.
Methods
This post hoc analysis of the COCOMO-ACS trial used serum samples from forty-five patients with non-ST elevation MI who underwent blood collection and optical coherence tomography (OCT) imaging of non-culprit, lipid-rich coronary plaques at baseline and after a median of 17.8 months. Serum syndecan-1 and endocan concentrations at both time-points were measured by ELISA. Relationships between these biomarkers and OCT parameters of rupture-prone plaque were examined.
Results
Serum levels of syndecan-1 (median 161.0 ng/mL at baseline vs 93.5 ng/mL at follow-up, P < 0.0001) and endocan (225.7 pg/mL vs 191.2 pg/mL, P = 0.003) both decreased from time of MI to follow-up, with strong correlation between their changes (R2 = 0.64, P < 0.0001). Only syndecan-1 showed a weak negative correlation with minimum fibrous cap thickness at baseline (R2 = 0.10, P = 0.03) and a weak positive correlation with maximum lipid arc at follow-up (R2 = 0.14, P = 0.01). While syndecan-1 and endocan showed no relationship with plasma lipid concentrations, there were weak associations between follow-up syndecan-1 and interleukin-1-beta (R2 = 0.21, P = 0.001), and follow-up endocan and interleukin-6 (R2 = 0.15, P = 0.008).
Conclusions
Although serum syndecan-1 and endocan levels decreased in peripheral blood over time post-MI on guideline-directed therapy, this study identified only modest relationships between syndecan-1 (and not endocan) and OCT compositional characteristics of lipid-rich, rupture-prone plaque.
syndecan -1和endocan是内皮损伤的生物标志物,与心肌梗死(MI)后较差的预后相关。由于尚不清楚这是如何介导的,我们研究了它们与急性心肌梗死后残留的非罪魁祸首冠状动脉粥样硬化斑块的组成之间的关系。方法对COCOMO-ACS试验进行的事后分析使用了45例非st段抬高心肌梗死患者的血清样本,这些患者在基线和中位时间17.8个月后接受了采血和光学相干断层扫描(OCT)对非罪魁祸首、富含脂质的冠状动脉斑块进行了成像。ELISA法测定两个时间点血清syndecan-1和endocan浓度。研究了这些生物标志物与易破裂斑块OCT参数之间的关系。结果血清syndecan-1水平(基线时中位数为161.0 ng/mL,随访时中位数为93.5 ng/mL, P < 0.0001)和endocan水平(225.7 pg/mL,随访时中位数为191.2 pg/mL, P = 0.003)从心肌梗死到随访期间均下降,两者变化具有很强的相关性(R2 = 0.64, P < 0.0001)。只有syndecan-1与基线时最小纤维帽厚度呈弱负相关(R2 = 0.10, P = 0.03),与随访时最大脂质弧呈弱正相关(R2 = 0.14, P = 0.01)。虽然syndecan-1和endocan与血浆脂质浓度无相关性,但随访时syndecan-1与白细胞介素-1- β (R2 = 0.21, P = 0.001)、endocan与白细胞介素-6 (R2 = 0.15, P = 0.008)存在弱相关性。结论:尽管经指导治疗的心肌梗死后,外周血中血清syndecan-1和endocan水平随着时间的推移而下降,但本研究仅发现syndecan-1(而非endocan)与富含脂质、易破裂斑块的OCT组成特征之间存在适度关系。
{"title":"Syndecan-1, endocan and non-culprit coronary plaque composition following non-ST elevation myocardial infarction","authors":"Naomi E. Wattchow , Thalia Salagaras , Mau T. Nguyen , Lauren Y.J. Sandeman , Gemma A. Figtree , Giuseppe Di Giovanni , Dennis T.L. Wong , Stephen J. Nicholls , Christina A. Bursill , Peter J. Psaltis","doi":"10.1016/j.ijcha.2025.101865","DOIUrl":"10.1016/j.ijcha.2025.101865","url":null,"abstract":"<div><h3>Background</h3><div>Syndecan-1 and endocan are biomarkers of endothelial damage, which associate with worse outcomes after myocardial infarction (MI). As it is unclear how this is mediated, we investigated how they associate with the composition of residual, non-culprit coronary atherosclerotic plaques following acute MI.</div></div><div><h3>Methods</h3><div>This <em>post hoc</em> analysis of the COCOMO-ACS trial used serum samples from forty-five patients with non-ST elevation MI who underwent blood collection and optical coherence tomography (OCT) imaging of non-culprit, lipid-rich coronary plaques at baseline and after a median of 17.8 months. Serum syndecan-1 and endocan concentrations at both time-points were measured by ELISA. Relationships between these biomarkers and OCT parameters of rupture-prone plaque were examined.</div></div><div><h3>Results</h3><div>Serum levels of syndecan-1 (median 161.0 ng/mL at baseline vs 93.5 ng/mL at follow-up, P < 0.0001) and endocan (225.7 pg/mL vs 191.2 pg/mL, P = 0.003) both decreased from time of MI to follow-up, with strong correlation between their changes (R<sup>2</sup> = 0.64, P < 0.0001). Only syndecan-1 showed a weak negative correlation with minimum fibrous cap thickness at baseline (R<sup>2</sup> = 0.10, P = 0.03) and a weak positive correlation with maximum lipid arc at follow-up (R<sup>2</sup> = 0.14, P = 0.01). While syndecan-1 and endocan showed no relationship with plasma lipid concentrations, there were weak associations between follow-up syndecan-1 and interleukin-1-beta (R<sup>2</sup> = 0.21, P = 0.001), and follow-up endocan and interleukin-6 (R<sup>2</sup> = 0.15, P = 0.008).</div></div><div><h3>Conclusions</h3><div>Although serum syndecan-1 and endocan levels decreased in peripheral blood over time post-MI on guideline-directed therapy, this study identified only modest relationships between syndecan-1 (and not endocan) and OCT compositional characteristics of lipid-rich, rupture-prone plaque.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101865"},"PeriodicalIF":2.5,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924324","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}
Pub Date : 2026-01-06DOI: 10.1016/j.ijcha.2025.101853
Paulo Roberto Benchimol-Barbosa
{"title":"On the mh-index and simple efficiency metrics for Assessing scientific contributions","authors":"Paulo Roberto Benchimol-Barbosa","doi":"10.1016/j.ijcha.2025.101853","DOIUrl":"10.1016/j.ijcha.2025.101853","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101853"},"PeriodicalIF":2.5,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924280","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}
Pub Date : 2026-01-06DOI: 10.1016/j.ijcha.2025.101859
Huang Yimei , Chen xinyun , Hu yuchi, Dai Songyuan, Nian Siqi, Li Hongning, Weng Shenghai, He Guanghui, Hua Baotong, Zhao Lulu
Background
The pathophysiology of heart failure with preserved ejection fraction (HFpEF) remains incompletely understood.
Objective
This study aimed to identify potential protein biomarkers for the accurate diagnosis and phenotyping of HFpEF and to construct a machine learning-based diagnostic model incorporating these biomarkers and key clinical features.
Methods
In a cross-sectional study of 249 cardiac patients, HFpEF-associated plasma proteins were identified using Olink PEA and validated by ELISA. A machine learning nomogram was developed and its diagnostic performance was evaluated.
Results
Analysis identified 92 plasma proteins,among which Serine protease 27(PRSS27), P-selectin glycoprotein ligand 1 (PSGL-1), Biregional Cell Adhesion Molecule-related (BOC), NF-κB essential modulator (NEMO), Glyoxalase 1(GLO1))) were specifically expressed in HFpEF group. Enrichment analysis indicated these differential proteins were primarily involved in inflammatory response, immune response, and the Phosphatidylinositol 3-kinase-AKT serine/threonine kinase (PI3K-AKT) signaling pathway. A diagnostic model integrating three proteins with clinical features (LDL-C, ALB) demonstrated excellent performance (AUC: 0.895), showing strong discriminatory power, good calibration, and potential clinical applicability.
Conclusion
This study identifies potential protein biomarkers for HFpEF diagnosis, provides new insights into its pathophysiology, and offers a practical diagnostic tool for clinical use.
{"title":"Identification of novel candidate biomarkers for heart failure with preserved ejection fraction by the Olink proteomics platform","authors":"Huang Yimei , Chen xinyun , Hu yuchi, Dai Songyuan, Nian Siqi, Li Hongning, Weng Shenghai, He Guanghui, Hua Baotong, Zhao Lulu","doi":"10.1016/j.ijcha.2025.101859","DOIUrl":"10.1016/j.ijcha.2025.101859","url":null,"abstract":"<div><h3>Background</h3><div>The pathophysiology of heart failure with preserved ejection fraction (HFpEF) remains incompletely understood.</div></div><div><h3>Objective</h3><div>This study aimed to identify potential protein biomarkers for the accurate diagnosis and phenotyping of HFpEF and to construct a machine learning-based diagnostic model incorporating these biomarkers and key clinical features.</div></div><div><h3>Methods</h3><div>In a cross-sectional study of 249 cardiac patients, HFpEF-associated plasma proteins were identified using Olink PEA and validated by ELISA. A machine learning nomogram was developed and its diagnostic performance was evaluated.</div></div><div><h3>Results</h3><div>Analysis identified 92 plasma proteins,among which Serine protease 27(PRSS27), P-selectin glycoprotein ligand 1 (PSGL-1), Biregional Cell Adhesion Molecule-related (BOC), NF-κB essential modulator (NEMO), Glyoxalase 1(GLO1))) were specifically expressed in HFpEF group. Enrichment analysis indicated these differential proteins were primarily involved in inflammatory response, immune response, and the Phosphatidylinositol 3-kinase-AKT serine/threonine kinase (PI3K-AKT) signaling pathway. A diagnostic model integrating three proteins with clinical features (LDL-C, ALB) demonstrated excellent performance (AUC: 0.895), showing strong discriminatory power, good calibration, and potential clinical applicability.</div></div><div><h3>Conclusion</h3><div>This study identifies potential protein biomarkers for HFpEF diagnosis, provides new insights into its pathophysiology, and offers a practical diagnostic tool for clinical use.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101859"},"PeriodicalIF":2.5,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924321","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}
Pub Date : 2026-01-06DOI: 10.1016/j.ijcha.2025.101856
Peter C. Murray , Ailis Pollock , Katie Hewitt , Jenna O’Sullivan , Aoife Sheahan , Richard Sheahan
<div><h3>Background / Aims</h3><div>Cardiomyopathy is universally penetrant in young adults with Duchenne muscular dystrophy (DMD), and is increasingly the preponderant cause of death. We describe the ECG, echocardiography and cardiac MRI (CMR) findings associated with this disease, and the level of agreement between imaging modalities, highlighting the obstacles encountered in high rates of failed diagnostic cardiac imaging in our DMD multidisciplinary care centre.</div></div><div><h3>Methods and results</h3><div>We followed all patients attending a Comprehensive Multidisciplinary Adult DMD clinic over 4 years. All attendees underwent transthoracic echocardiography (TTE) and were offered referral for cardiac MRI (CMR). We recorded baseline demographics, ECG characteristics and imaging findings, comparing TTE and CMR derived LVEF. A total of 33 patients enrolled, median age 20, with mean follow-up of 3 years and 3 months. Common ECG abnormalities were dominant R in V1, pathological Q waves and right axis deviation. Mean LVEF was 51 % at enrollment and 45 % at follow-up by TTE. Presence of any degree of mitral regurgitation correlated strongly to left ventricular systolic dysfunction. CMR was completed in just 25 % of patients, all of whom had extensive midwall fibrosis. Of those in whom CMR failed, 52 % were unable to lie flat or position correctly for scanning, predominantly due to muscle contractures. Despite suboptimal TTE imaging in 75 %, there was good agreement in LVEF between CMR and TTE.</div></div><div><h3>Conclusion</h3><div>We found a high rate of failure to complete diagnostic cardiac imaging in this group of patients with impaired mobility predominantly due to fixed flexion deformities, inability to lay flat or to tolerate the scan. Our study highlights the critical need to provided specially trained Echo and CMR sonographers who understand the challenges to optimal quality imaging in these patients, and who are appropriately supported by Health Care Assistants (HCA) who are familiar with careful positioning to facilitate optimal imaging. Never the less, the study highlights the importance of multimodality imaging, and practical strategies to overcome environmental obstacles to diagnostic imaging, to better guide aggressiveness of treatment for DMD and its inherent cardiomyopathy.</div><div>Key Learning Points.</div><div>What is already known:<ul><li><span>•</span><span><div>In addition to significant mobility impairment, Duchenne muscular dystrophy (DMD) is associated with development of severe cardiomyopathy in childhood / early adulthood. Due to relatively recent improvements in survival, the evolution of ECG and imaging correlates in adulthood are poorly described.</div></span></li><li><span>•</span><span><div>The accuracy and degree of correlation between transthoracic echocardiography (TTE) and cardiac MRI (CMR) in this cohort is not known. Myocardial fibrosis, not evaluated on TTE, can be seen on cardiac CMR, and is thought to
{"title":"ECG and imaging manifestations of cardiomyopathy in adults with Duchenne muscular dystrophy","authors":"Peter C. Murray , Ailis Pollock , Katie Hewitt , Jenna O’Sullivan , Aoife Sheahan , Richard Sheahan","doi":"10.1016/j.ijcha.2025.101856","DOIUrl":"10.1016/j.ijcha.2025.101856","url":null,"abstract":"<div><h3>Background / Aims</h3><div>Cardiomyopathy is universally penetrant in young adults with Duchenne muscular dystrophy (DMD), and is increasingly the preponderant cause of death. We describe the ECG, echocardiography and cardiac MRI (CMR) findings associated with this disease, and the level of agreement between imaging modalities, highlighting the obstacles encountered in high rates of failed diagnostic cardiac imaging in our DMD multidisciplinary care centre.</div></div><div><h3>Methods and results</h3><div>We followed all patients attending a Comprehensive Multidisciplinary Adult DMD clinic over 4 years. All attendees underwent transthoracic echocardiography (TTE) and were offered referral for cardiac MRI (CMR). We recorded baseline demographics, ECG characteristics and imaging findings, comparing TTE and CMR derived LVEF. A total of 33 patients enrolled, median age 20, with mean follow-up of 3 years and 3 months. Common ECG abnormalities were dominant R in V1, pathological Q waves and right axis deviation. Mean LVEF was 51 % at enrollment and 45 % at follow-up by TTE. Presence of any degree of mitral regurgitation correlated strongly to left ventricular systolic dysfunction. CMR was completed in just 25 % of patients, all of whom had extensive midwall fibrosis. Of those in whom CMR failed, 52 % were unable to lie flat or position correctly for scanning, predominantly due to muscle contractures. Despite suboptimal TTE imaging in 75 %, there was good agreement in LVEF between CMR and TTE.</div></div><div><h3>Conclusion</h3><div>We found a high rate of failure to complete diagnostic cardiac imaging in this group of patients with impaired mobility predominantly due to fixed flexion deformities, inability to lay flat or to tolerate the scan. Our study highlights the critical need to provided specially trained Echo and CMR sonographers who understand the challenges to optimal quality imaging in these patients, and who are appropriately supported by Health Care Assistants (HCA) who are familiar with careful positioning to facilitate optimal imaging. Never the less, the study highlights the importance of multimodality imaging, and practical strategies to overcome environmental obstacles to diagnostic imaging, to better guide aggressiveness of treatment for DMD and its inherent cardiomyopathy.</div><div>Key Learning Points.</div><div>What is already known:<ul><li><span>•</span><span><div>In addition to significant mobility impairment, Duchenne muscular dystrophy (DMD) is associated with development of severe cardiomyopathy in childhood / early adulthood. Due to relatively recent improvements in survival, the evolution of ECG and imaging correlates in adulthood are poorly described.</div></span></li><li><span>•</span><span><div>The accuracy and degree of correlation between transthoracic echocardiography (TTE) and cardiac MRI (CMR) in this cohort is not known. Myocardial fibrosis, not evaluated on TTE, can be seen on cardiac CMR, and is thought to","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101856"},"PeriodicalIF":2.5,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924322","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}
Pub Date : 2025-12-17DOI: 10.1016/j.ijcha.2025.101854
Miika Vanhanen , Jussi Jaakkola , Juhani K.E. Airaksinen , Olli Halminen , Jukka Putaala , Pirjo Mustonen , Jari Haukka , Juha Hartikainen , Alex Luojus , Mikko Niemi , Miika Linna , Mika Lehto , Konsta Teppo
Objective
Patients with alcohol use disorder (AUD) often receive inferior treatment for somatic comorbidities. We aimed to examine whether AUD is associated with disparities in the use of antiarrhythmic therapies (AAT) for rhythm control in atrial fibrillation (AF) patients, using a nationwide registry.
Methods
The Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) registry includes all 229,565 patients with incident AF diagnosed in Finland between 2007 and 2018, identified from comprehensive national healthcare registries. The primary outcome was initiation of rhythm control therapies, including antiarrhythmic drugs, cardioversion, and catheter ablation, in patients with and without AUD.
Results
The mean age was 72.7 years, 50 % were female and 4.7 % had AUD. Rhythm control was initiated less often in patients with AUD compared to those without (13.6 % vs. 21.8 %, p < 0.001). After adjustment for comorbidities and socioeconomic status, AUD remained associated with lower use of rhythm control therapies (HR 0.65; 95 % CI 0.62–0.69). This disparity was consistent across all modalities of rhythm control (antiarrhythmic drugs, cardioversion and catheter ablation). While no significant interaction was observed with sex or age, income modified the association (p < 0.001), with the lowest income tertile showing the greatest disparity (HR 0.37; 95 % CI 0.32–0.42).
Conclusions
AUD is independently associated with markedly lower use of rhythm control therapies in AF patients. These disparities are most pronounced among socioeconomically disadvantaged individuals, highlighting the need for targeted interventions to ensure equitable treatment access.
{"title":"Alcohol use disorder and use of rhythm control therapies in patients with atrial fibrillation: A nationwide cohort study","authors":"Miika Vanhanen , Jussi Jaakkola , Juhani K.E. Airaksinen , Olli Halminen , Jukka Putaala , Pirjo Mustonen , Jari Haukka , Juha Hartikainen , Alex Luojus , Mikko Niemi , Miika Linna , Mika Lehto , Konsta Teppo","doi":"10.1016/j.ijcha.2025.101854","DOIUrl":"10.1016/j.ijcha.2025.101854","url":null,"abstract":"<div><h3>Objective</h3><div>Patients with alcohol use disorder (AUD) often receive inferior treatment for somatic comorbidities. We aimed to examine whether AUD is associated with disparities in the use of antiarrhythmic therapies (AAT) for rhythm control in atrial fibrillation (AF) patients, using a nationwide registry.</div></div><div><h3>Methods</h3><div>The Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) registry includes all 229,565 patients with incident AF diagnosed in Finland between 2007 and 2018, identified from comprehensive national healthcare registries. The primary outcome was initiation of rhythm control therapies, including antiarrhythmic drugs, cardioversion, and catheter ablation, in patients with and without AUD.</div></div><div><h3>Results</h3><div>The mean age was 72.7 years, 50 % were female and 4.7 % had AUD. Rhythm control was initiated less often in patients with AUD compared to those without (13.6 % vs. 21.8 %, p < 0.001). After adjustment for comorbidities and socioeconomic status, AUD remained associated with lower use of rhythm control therapies (HR 0.65; 95 % CI 0.62–0.69). This disparity was consistent across all modalities of rhythm control (antiarrhythmic drugs, cardioversion and catheter ablation). While no significant interaction was observed with sex or age, income modified the association (p < 0.001), with the lowest income tertile showing the greatest disparity (HR 0.37; 95 % CI 0.32–0.42).</div></div><div><h3>Conclusions</h3><div>AUD is independently associated with markedly lower use of rhythm control therapies in AF patients. These disparities are most pronounced among socioeconomically disadvantaged individuals, highlighting the need for targeted interventions to ensure equitable treatment access.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101854"},"PeriodicalIF":2.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789550","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}
Pub Date : 2025-12-11DOI: 10.1016/j.ijcha.2025.101851
Rebeca Lorca , Alberto Alen , Carlos Moliner-Abós , Fernando de Frutos , Néstor Báez-Ferrer , María Luisa Peña-Peña , Eduardo Villacorta , Tomas Ripoll-Vera , Esther Zorio , Aaron Martínez-Gimeno , José Bermúdez-Jiménez , Javier Limeres , Coloma Tiron , José M. Larrañaga-Moreira , Eva Cabrera-Romero , Pablo García-Pavía , María Angeles Espinosa , Jesús Piqueras , Soledad García-Hernández , Julián Palomino-Doza , Carmen Muñoz
Background
DM1 is an autosomal dominant disorder caused by unstable CTG repeats that expand over lifetime and in successive generations, contributing to genetic anticipation. Cardiac conduction abnormalities (CCAs) are a major source of morbidity and premature death in DM1, yet the influence of age at diagnosis, generation, and CTG repeat length on the timing and progression of cardiac involvement remains poorly defined.
Method
This multicentric retrospective study included 549 adult DM1 patients from 16 hospitals in Spain. The primary composite endpoint comprised significant CCAs, device implantation, malignant ventricular arrhythmias and cardiac syncope. Patients were stratified by age‑at‑diagnosis (<40, 40–59, and ≥60 years); birth generation (1920–1965, 1966–1990, 1991–2015), and CTG repeat length (<100, 100–599, and ≥600).
Results
During follow‑up, 33.1 % of patients experienced the primary endpoint. This risk was 4.7‑fold higher in the youngest group versus the oldest group (HR 4.70; p < 0.001); 35‑fold higher in the 3rd generation versus the 1st and increased progressively with longer CTG expansions. Device implantation rates were likewise higher in younger patients, later generations, and those with larger repeat lengths.
Conclusion
The results demonstrate a striking anticipation pattern in the cardiac phenotype of DM1, with progressively earlier and more severe electrical disease paralleling CTG expansion across generations. Incorporating age at diagnosis, generational cohort, and genetic repeat burden into clinical assessment may enhance risk stratification and enable earlier, targeted rhythm surveillance and device therapy to prevent sudden cardiac death in DM1.
ddm1是一种常染色体显性遗传病,由不稳定的CTG重复序列在一生中和连续几代中扩展引起,有助于遗传预期。心传导异常(CCAs)是DM1发病和过早死亡的主要原因,但诊断年龄、世代和CTG重复长度对心脏受累时间和进展的影响仍不明确。方法本多中心回顾性研究纳入西班牙16家医院549例成年DM1患者。主要复合终点包括显著cca、器械植入、恶性室性心律失常和心源性晕厥。患者按诊断年龄分层(40岁、40 - 59岁和≥60岁);出生世代(1920-1965、1966-1990、1991-2015)和CTG重复长度(<;100、100 - 599和≥600)。结果在随访期间,33.1%的患者达到了主要终点。这一风险在最年轻组比最年长组高4.7倍(HR 4.70; p < 0.001);第三代比第一代高35倍,并随着CTG扩展时间的延长而逐渐增加。同样,在年轻患者、后代患者和重复长度较大的患者中,器械植入率也较高。结果表明,DM1的心脏表型具有显著的预测模式,随着CTG的代际扩展,电性疾病的发生时间越来越早,越来越严重。将诊断年龄、世代队列和遗传重复负担纳入临床评估可能会加强风险分层,并使早期、有针对性的节律监测和器械治疗成为可能,以预防DM1的心源性猝死。
{"title":"Genetic anticipation and cardiac conduction abnormalities in myotonic dystrophy type 1: implications for early stratification from a multicenter registry","authors":"Rebeca Lorca , Alberto Alen , Carlos Moliner-Abós , Fernando de Frutos , Néstor Báez-Ferrer , María Luisa Peña-Peña , Eduardo Villacorta , Tomas Ripoll-Vera , Esther Zorio , Aaron Martínez-Gimeno , José Bermúdez-Jiménez , Javier Limeres , Coloma Tiron , José M. Larrañaga-Moreira , Eva Cabrera-Romero , Pablo García-Pavía , María Angeles Espinosa , Jesús Piqueras , Soledad García-Hernández , Julián Palomino-Doza , Carmen Muñoz","doi":"10.1016/j.ijcha.2025.101851","DOIUrl":"10.1016/j.ijcha.2025.101851","url":null,"abstract":"<div><h3>Background</h3><div>DM1 is an autosomal dominant disorder caused by unstable CTG repeats that expand over lifetime and in successive generations, contributing to genetic anticipation. Cardiac conduction abnormalities (CCAs) are a major source of morbidity and premature death in DM1, yet the influence of age at diagnosis, generation, and CTG repeat length on the timing and progression of cardiac involvement remains poorly defined.</div></div><div><h3>Method</h3><div>This multicentric retrospective study included 549 adult DM1 patients from 16 hospitals in Spain. The primary composite endpoint comprised significant CCAs, device implantation, malignant ventricular arrhythmias and cardiac syncope. Patients were stratified by age‑at‑diagnosis (<40, 40–59, and ≥60 years); birth generation (1920–1965, 1966–1990, 1991–2015), and CTG repeat length (<100, 100–599, and ≥600).</div></div><div><h3>Results</h3><div>During follow‑up, 33.1 % of patients experienced the primary endpoint. This risk was 4.7‑fold higher in the youngest group versus the oldest group (HR 4.70; p < 0.001); 35‑fold higher in the 3rd generation versus the 1st and increased progressively with longer CTG expansions. Device implantation rates were likewise higher in younger patients, later generations, and those with larger repeat lengths.</div></div><div><h3>Conclusion</h3><div>The results demonstrate a striking anticipation pattern in the cardiac phenotype of DM1, with progressively earlier and more severe electrical disease paralleling CTG expansion across generations. Incorporating age at diagnosis, generational cohort, and genetic repeat burden into clinical assessment may enhance risk stratification and enable earlier, targeted rhythm surveillance and device therapy to prevent sudden cardiac death in DM1.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101851"},"PeriodicalIF":2.5,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737407","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}
Pub Date : 2025-12-10DOI: 10.1016/j.ijcha.2025.101849
Shabiga Sivanesan , Aleksandra Gąsecka , Niels M.R. van der Sangen , Wout W.A. van den Broek , Jaouad Azzahhafi , Dean R.P.P. Chan Pin Yin , Qiu Ying F. van de Pol , Ronald J. Walhout , Melvyn Tjon Joe Gin , Ron Pisters , Deborah M. Nicastia , Gerben J. de Roest , Georgios J. Vlachojannis , Rutger J. van Bommel , Wouter J. Kikkert , José P.S. Henriques , Jurriën M. ten Berg , Yolande Appelman
Aims
This study reports sex differences in the clinical presentation, treatment management and outcomes of patients with acute coronary syndrome (ACS) in The Netherlands, using data from the FORCE-ACS registry.
Methods
A prospective analysis was conducted using data from 5023 patients admitted with ACS between 2015 and 2019, with complete three-year follow-up. Demographic data, clinical characteristics, in-hospital treatment and outcomes were compared by sex. Multivariable regression analyses explored associations between sex and clinical outcomes.
Results
Of the 5023 patients, 29 % were women. Women were generally older, with a significantly higher prevalence of hypertension (61.7 % vs 54.2 %), chronic kidney disease (25.7 % vs. 18.5 %) and myocardial infarction with non-obstructive coronary arteries (MINOCA) (13.5 % vs. 6.5 %). Women less frequently underwent revascularisation, even after excluding those with non-obstructive coronary artery disease, and received less medical treatment compared to their male counterparts. At 36 months, women had higher unadjusted mortality rate (13.7 % vs. 11.0 %, OR 1.28, 95 % CI: 1.07–1.54) and bleeding events (26.2 % vs. 22.3 %, OR 1.24, 95 % CI: 1.08–1.43). However, after adjustment for age and baseline characteristics, these differences were no longer statistically significant. Recurrent ACS and stroke remained similar in both groups, also after correction.
Conclusion
Differences between women and men were observed in clinical presentation, interventional treatment, pharmacotherapy and outcomes among ACS patients in The Netherlands. Despite receiving less guideline-recommended care, women had similar adjusted 36-month outcomes as men. These findings show that there is room for improvement in the management of ACS, with a focus on optimized treatment strategies for women.
{"title":"Sex differences in the presentation and management of acute coronary syndrome patients: Insights from the FORCE-ACS registry","authors":"Shabiga Sivanesan , Aleksandra Gąsecka , Niels M.R. van der Sangen , Wout W.A. van den Broek , Jaouad Azzahhafi , Dean R.P.P. Chan Pin Yin , Qiu Ying F. van de Pol , Ronald J. Walhout , Melvyn Tjon Joe Gin , Ron Pisters , Deborah M. Nicastia , Gerben J. de Roest , Georgios J. Vlachojannis , Rutger J. van Bommel , Wouter J. Kikkert , José P.S. Henriques , Jurriën M. ten Berg , Yolande Appelman","doi":"10.1016/j.ijcha.2025.101849","DOIUrl":"10.1016/j.ijcha.2025.101849","url":null,"abstract":"<div><h3>Aims</h3><div>This study reports sex differences in the clinical presentation, treatment management and outcomes of patients with acute coronary syndrome (ACS) in The Netherlands, using data from the FORCE-ACS registry.</div></div><div><h3>Methods</h3><div>A prospective analysis was conducted using data from 5023 patients admitted with ACS between 2015 and 2019, with complete three-year follow-up. Demographic data, clinical characteristics, in-hospital treatment and outcomes were compared by sex. Multivariable regression analyses explored associations between sex and clinical outcomes.</div></div><div><h3>Results</h3><div>Of the 5023 patients, 29 % were women. Women were generally older, with a significantly higher prevalence of hypertension (61.7 % vs 54.2 %), chronic kidney disease (25.7 % vs. 18.5 %) and myocardial infarction with non-obstructive coronary arteries (MINOCA) (13.5 % vs. 6.5 %). Women less frequently underwent revascularisation, even after excluding those with non-obstructive coronary artery disease, and received less medical treatment compared to their male counterparts. At 36 months, women had higher unadjusted mortality rate (13.7 % vs. 11.0 %, OR 1.28, 95 % CI: 1.07–1.54) and bleeding events (26.2 % vs. 22.3 %, OR 1.24, 95 % CI: 1.08–1.43). However, after adjustment for age and baseline characteristics, these differences were no longer statistically significant. Recurrent ACS and stroke remained similar in both groups, also after correction.</div></div><div><h3>Conclusion</h3><div>Differences between women and men were observed in clinical presentation, interventional treatment, pharmacotherapy and outcomes among ACS patients in The Netherlands. Despite receiving less guideline-recommended care, women had similar adjusted 36-month outcomes as men. These findings show that there is room for improvement in the management of ACS, with a focus on optimized treatment strategies for women.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101849"},"PeriodicalIF":2.5,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737345","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}
Pub Date : 2025-12-03DOI: 10.1016/j.ijcha.2025.101847
Juan C Grignola , Pedro Trujillo , Julio Sandoval , Enric Domingo
The acute vasodilator challenge during right heart catheterization (RHC) provides a deeper understanding of the pulmonary circulation by assessing vasoreactivity. The current criteria for a positive acute vasoreactivity test (AVT) are simplified to steady-state metrics, based on cutoff points derived from expert opinion. A positive AVT identifies a specific, but very rare, PH phenotype that may respond long-term to calcium-channel blockers. Growing evidence supports updating the role and criteria of AVT in pulmonary arterial hypertension, broadening its use to other PH groups, and potentially offering new insights for predicting risk and/or treatment outcomes.
This study aims to revisit the uses, criteria, and goals of AVT in patients with PH beyond group 1 and to propose a new approach for phenotyping the pulmonary vascular response to the acute vasodilator challenge during diagnostic RHC. We propose a continuous multi-parameter criterion to evaluate the entire right ventricular afterload during AVT, such as the pulmonary vascular resistance-pulmonary arterial capacitance curve and alpha distensibility coefficient. AVT could assess the residual vasoreactive reserve of the pulmonary circulation as a provocative test for predicting risk outcomes and/or treatment responses.
{"title":"Acute pulmonary vasoreactivity: a simple test revisited in the contemporary era − a narrative review","authors":"Juan C Grignola , Pedro Trujillo , Julio Sandoval , Enric Domingo","doi":"10.1016/j.ijcha.2025.101847","DOIUrl":"10.1016/j.ijcha.2025.101847","url":null,"abstract":"<div><div>The acute vasodilator challenge during right heart catheterization (RHC) provides a deeper understanding of the pulmonary circulation by assessing vasoreactivity. The current criteria for a positive acute vasoreactivity test (AVT) are simplified to steady-state metrics, based on cutoff points derived from expert opinion. A positive AVT identifies a specific, but very rare, PH phenotype that may respond long-term to calcium-channel blockers. Growing evidence supports updating the role and criteria of AVT in pulmonary arterial hypertension, broadening its use to other PH groups, and potentially offering new insights for predicting risk and/or treatment outcomes.</div><div>This study aims to revisit the uses, criteria, and goals of AVT in patients with PH beyond group 1 and to propose a new approach for phenotyping the pulmonary vascular response to the acute vasodilator challenge during diagnostic RHC. We propose a continuous multi-parameter criterion to evaluate the entire right ventricular afterload during AVT, such as the pulmonary vascular resistance-pulmonary arterial capacitance curve and alpha distensibility coefficient. AVT could assess the residual vasoreactive reserve of the pulmonary circulation as a provocative test for predicting risk outcomes and/or treatment responses.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101847"},"PeriodicalIF":2.5,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684636","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}
Pub Date : 2025-12-01DOI: 10.1016/j.ijcha.2025.101836
Riaz Jiffry , Ankit Gupta , Jeisun Poornaselvan , Valerie Mok , Arkadeep Dhali , Aditi Gupta , Tong Liu , Gary Tse , Helen Ye Rim Huang
Fatty acid-binding proteins (FABPs) are intracellular lipid-binding proteins that significantly contribute to the transport and metabolism of long-chain fatty acids and other hydrophobic ligands. In this review, we focus on the role of heart-type FABP (H-FABPs) as diagnostic and prognostic biomarkers in several cardiovascular diseases. Despite its advantages over troponins and other cardiac biomarkers, H-FABP remains underutilized in clinical practice. The aim of this review is to reassess the role of H-FABPs across various cardiovascular pathologies and promote their adoption into standard clinical practice. Elevated H-FABP levels have been associated with worse outcomes in CAD and serve as sensitive markers for myocardial injury during the early stages of MI and reperfusion. Furthermore, we discuss the potential of H-FABPs in risk stratification for stable CAD and their utility in predicting long-term outcomes post-MI. The prognostic value of H-FABP in cardiac events such as heart failure, pulmonary embolism, and arrhythmias, alongside its application in peripheral arterial disease and non-ischemic dilated cardiomyopathy, highlights its importance in cardiovascular medicine. Given the global burden of cardiovascular diseases, understanding and utilising H-FABPs could enhance patient management through better risk assessment and early diagnosis.
{"title":"Diagnostic and prognostic utility of heart-type fatty acid binding proteins in cardiovascular diseases and risk factors − an updated review of the literature","authors":"Riaz Jiffry , Ankit Gupta , Jeisun Poornaselvan , Valerie Mok , Arkadeep Dhali , Aditi Gupta , Tong Liu , Gary Tse , Helen Ye Rim Huang","doi":"10.1016/j.ijcha.2025.101836","DOIUrl":"10.1016/j.ijcha.2025.101836","url":null,"abstract":"<div><div>Fatty acid-binding proteins (FABPs) are intracellular lipid-binding proteins that significantly contribute to the transport and metabolism of long-chain fatty acids and other hydrophobic ligands. In this review, we focus on the role of heart-type FABP (H-FABPs) as diagnostic and prognostic biomarkers in several cardiovascular diseases. Despite its advantages over troponins and other cardiac biomarkers, H-FABP remains underutilized in clinical practice. The aim of this review is to reassess the role of H-FABPs across various cardiovascular pathologies and promote their adoption into standard clinical practice. Elevated H-FABP levels have been associated with worse outcomes in CAD and serve as sensitive markers for myocardial injury during the early stages of MI and reperfusion. Furthermore, we discuss the potential of H-FABPs in risk stratification for stable CAD and their utility in predicting long-term outcomes post-MI. The prognostic value of H-FABP in cardiac events such as heart failure, pulmonary embolism, and arrhythmias, alongside its application in peripheral arterial disease and non-ischemic dilated cardiomyopathy, highlights its importance in cardiovascular medicine. Given the global burden of cardiovascular diseases, understanding and utilising H-FABPs could enhance patient management through better risk assessment and early diagnosis.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101836"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684761","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}