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Serum aminoterminal type III procollagen peptide reflects increased vascular thickness in healthy, young adults 血清氨基末端III型前胶原肽反映健康年轻人血管厚度增加
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-23 DOI: 10.1016/j.ijcha.2026.101876
Manar Bitar , Dieter Samyn , Madeleine Helgesson , Martin Vink , Paul Pettersson-Pablo

Background

Procollagen III, aminoterminal peptide (PIIINP) is a degradation product of collagen type III-synthesis. Collagen type III is distributed in many tissues, and an increase in serum PIIINP could reflect an increase in collagen turnover and pro-fibrotic activity. In this study, on a population of younger, healthy adults, we examined whether serum PIIINP correlates with early markers of vascular health, to evaluate its potential as a biomarker for early screening of preclinical cardiovascular risk.

Methods

PIIINP levels, pulse wave velocity (PWV) and Carotid-intima media thickness (cIMT) was measured in 834 healthy, non-smoking, individuals aged 18–26. In univariable and multivariable linear regression models, we examined the association between PIIINP and vascular measurements, PWV and cIMT with adjustment for serum lipids, liver enzymes and systolic blood pressure.

Results

The average of PIIINP, PWV and cIMT measurements in this population, were low (7.1 and 7.3 µg/L, 5.5 and 5.2 m/s, and 0.50 and 0.49 mm for men and women, respectively). In univariable analyses, PIIINP correlated positively with cIMT (p = 0.0061) and negatively with PWV (p = 0.0069). In multivariable analyses, a statistically significant association remained between PIIINP and cIMT (p < 0.001), but not with PWV.

Conclusion

Serum PIIINP correlates with cIMT in a healthy population, indicating its potential as a biomarker of cardiovascular risk at a preclinical stage. PIIINP measurement being easier to perform and less examiner dependent than the more time consuming and cumbersome cIMT, are suggestive of its possible merits as an early screening tool for cardiovascular disease.
前胶原III,氨基末端肽(PIIINP)是III型胶原合成的降解产物。III型胶原分布在许多组织中,血清PIIINP的升高可以反映胶原转换和促纤维化活性的增加。在这项研究中,我们研究了一组年轻、健康的成年人,研究了血清PIIINP是否与血管健康的早期标志物相关,以评估其作为临床前心血管风险早期筛查的生物标志物的潜力。方法测定834例18 ~ 26岁健康、非吸烟人群的spiiinp水平、脉搏波速度(PWV)和颈动脉内膜中膜厚度(cIMT)。在单变量和多变量线性回归模型中,我们检验了PIIINP与血管测量、PWV和cIMT与血脂、肝酶和收缩压调整之间的关系。结果该人群PIIINP、PWV和cIMT的平均值较低(男性和女性分别为7.1和7.3µg/L, 5.5和5.2 m/s, 0.50和0.49 mm)。在单变量分析中,PIIINP与cIMT呈正相关(p = 0.0061),与PWV负相关(p = 0.0069)。在多变量分析中,PIIINP和cIMT之间仍然存在统计学上显著的相关性(p < 0.001),但与PWV无关。结论在健康人群中,血清PIIINP与cIMT相关,表明其有可能作为临床前阶段心血管风险的生物标志物。PIIINP测量比耗时和繁琐的cIMT更容易执行,对检查员的依赖程度更低,这表明它可能具有作为心血管疾病早期筛查工具的优点。
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引用次数: 0
Prognostic value of liver shear wave elastography after transcatheter aortic valve implantation in severe aortic stenosis 经导管主动脉瓣置入术后肝剪切波弹性成像对严重主动脉瓣狭窄患者的预后价值
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-22 DOI: 10.1016/j.ijcha.2025.101864
Yutaro Sato , Akihiko Sato , Kazuya Sakamoto , Yuuki Muto , Yu Sato , Tetsuro Yokokawa , Takeshi Shimizu , Tomofumi Misaka , Takashi Kaneshiro , Masayoshi Oikawa , Atsushi Kobayashi , Akiomi Yoshihisa , Yasuchika Takeishi

Background

Shear wave elastography (SWE) is a noninvasive ultrasound technique that quantifies liver stiffness. Previous studies have suggested that liver SWE can serve as an indirect marker of hepatic congestion. However, it remains unclear whether liver SWE measured after transcatheter aortic valve implantation (TAVI) is associated with clinical outcomes.

Methods

A total of 127 consecutive patients with severe aortic stenosis who underwent TAVI and had liver SWE measured using abdominal ultrasonography at discharge were enrolled. Liver SWE was obtained from the right hepatic lobe via an intercostal approach. Patients were stratified by the median liver SWE value (1.36 m/s): low-SWE group (< 1.36 m/s; n = 59) and high-SWE group (≥ 1.36 m/s; n = 68). The primary endpoint was a composite of all-cause death and heart failure (HF) rehospitalization.

Results

All 127 patients were followed for 24 months, during which 21 (16.5 %) experienced the primary endpoint. Kaplan–Meier analysis showed a higher cumulative incidence of the primary endpoint in the high-SWE group than in the low-SWE group (log-rank P = 0.019). In Cox proportional hazards models adjusted using inverse probability of treatment weighting, high liver SWE was independently associated with an increased risk of the primary endpoint (hazard ratio 3.66; 95 % confidence interval 1.30–10.32; P = 0.014).

Conclusion

High liver SWE after TAVI was independently associated with an increased 24-month risk of all-cause death and HF rehospitalization.
横波弹性成像(SWE)是一种量化肝脏硬度的无创超声技术。先前的研究表明肝脏SWE可以作为肝充血的间接标志。然而,目前尚不清楚经导管主动脉瓣植入术(TAVI)后肝脏SWE测量是否与临床结果相关。方法选取连续127例重度主动脉瓣狭窄患者,均行TAVI手术,出院时腹部超声测量肝脏SWE。肝SWE通过肋间入路从右肝叶获得。按肝脏SWE中值(1.36 m/s)分为低SWE组(< 1.36 m/s, n = 59)和高SWE组(≥1.36 m/s, n = 68)。主要终点是全因死亡和心力衰竭(HF)再住院。结果127例患者随访24个月,其中21例(16.5%)达到主要终点。Kaplan-Meier分析显示,高swe组的主要终点累积发生率高于低swe组(log-rank P = 0.019)。在使用治疗加权逆概率调整的Cox比例风险模型中,肝脏SWE高与主要终点风险增加独立相关(风险比3.66;95%可信区间1.30-10.32;P = 0.014)。结论TAVI术后高肝SWE与24个月全因死亡和HF再住院风险增加独立相关。
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引用次数: 0
Visual coronary calcium scoring to support opportunistic CAD screening: comparative evaluation of three established systems and introduction of a novel scoring system 视觉冠状动脉钙评分支持机会性CAD筛查:三种已建立的系统的比较评价和一种新的评分系统的介绍
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-19 DOI: 10.1016/j.ijcha.2026.101875
Philipp Nicol , Rafael Adolf , Salvatore Cassese , Adnan Kastrati , Michael Joner , Heribert Schunkert , Martin Hadamitzky , Leif-Christopher Engel

Background

Coronary artery calcium (CAC) scoring is an established marker of atherosclerotic burden and cardiovascular risk. While the Agatston score is the clinical gold standard, alternative visual scoring methods—including the Visual Ordinal Score, Weston Score, and Vessel-specific extent-based score—are increasingly used, particularly in non-gated or opportunistic CT imaging. This study aimed to compare the diagnostic performance, inter-observer reliability, and correlation of different visual scoring methods against the Agatston score.

Methods

A total of 299 cases were evaluated using ECG-gated CT scans. Each case was independently scored in a blinded fashion by two observers using three visual methods: (1) Visual Ordinal Score (VS), (2) Weston Score (WS) and (3) Vessel-specific extent-based score (VSES). A novel visual CAC score was derived by combining Weston and Vessel-specific extent-based scoring (= Weston Extent Score, WES). Cohen’s Kappa and Intraclass Correlation Coefficients (ICC) were used for inter-observer agreement. Classification performance was assessed against Agatston-based categories (No CAC, Mild, Moderate, Severe), including accuracy, precision, sensitivity, and specificity. Correlation analyses were conducted using Pearson and Spearman coefficients.

Results

All scoring methods showed high correlation with the Agatston score (Spearman ρ > 0.87; p < 0.001). Visual scoring demonstrated the highest inter-observer agreement (Kappa = 0.94, ICC = 0.97), followed by Weston (Kappa = 0.90) and Vessel-Specific scores (Kappa = 0.77). Visual scoring also yielded the highest accuracy (Observer 1: 91.3 %, Observer 2: 90.0 %) The newly derived WES score achieved 80.9 % accuracy, with macro-averaged specificity of 93.8 % and improving diagnostic accuracy compared to WS and VSES.

Discussion

Different visual scoring offers excellent reproducibility and diagnostic accuracy for CAC classification, with strong correlation to the Agatston score. The newly-derived WES score could be useful in providing a practical balance regarding volumetric information (CAC densitiy) and anatomical distribution of CAC. These findings support the implementation of structured visual CAC scoring in clinical and opportunistic CT settings.
背景:冠状动脉钙化(CAC)评分是动脉粥样硬化负担和心血管风险的一个既定标志。虽然Agatston评分是临床金标准,但其他视觉评分方法——包括视觉序数评分、Weston评分和血管特异性范围评分——越来越多地被使用,特别是在非门控或机会性CT成像中。本研究旨在比较不同视觉评分方法与Agatston评分的诊断性能、观察者间信度和相关性。方法对299例患者进行心电图门控CT扫描。每个病例由两名观察者以盲法独立评分,采用三种视觉方法:(1)视觉顺序评分(VS),(2)韦斯顿评分(WS)和(3)血管特异性程度评分(VSES)。结合Weston和血管特异性范围评分,得出了一种新的视觉CAC评分(= Weston范围评分,WES)。使用Cohen’s Kappa和class内相关系数(ICC)来衡量观察者间的一致性。根据agatston分类(无CAC、轻度、中度、重度)评估分类效果,包括准确性、精密度、敏感性和特异性。使用Pearson和Spearman系数进行相关分析。结果各评分方法均与Agatston评分高度相关(Spearman ρ > 0.87; p < 0.001)。视觉评分显示出最高的观察者间一致性(Kappa = 0.94, ICC = 0.97),其次是Weston评分(Kappa = 0.90)和Vessel-Specific评分(Kappa = 0.77)。视觉评分的准确率也最高(观察者1:91.3%,观察者2:90.0%)。新得出的WES评分准确率为80.9%,宏观平均特异性为93.8%,与WS和VSES相比,诊断准确率有所提高。不同的视觉评分为CAC分类提供了极好的再现性和诊断准确性,与Agatston评分有很强的相关性。新得出的WES评分可用于提供有关CAC的体积信息(CAC密度)和CAC的解剖分布的实际平衡。这些发现支持在临床和机会性CT设置中实施结构化视觉CAC评分。
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引用次数: 0
Clinical outcomes of SGLT2 inhibitor use in Thai patients with heart failure: a five-year retrospective cohort study 泰国心力衰竭患者使用SGLT2抑制剂的临床结果:一项为期五年的回顾性队列研究
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-18 DOI: 10.1016/j.ijcha.2026.101873
Thananan Chanchanayothin , Chuttikan Klomwong , Tanawit Saisri , Suphasin Panudom , Sakchai Chaiyamahapurk , Nonthikorn Theerasuwipakorn , Noppachai Siranart , Patavee Pajareya , Nattakorn Songsirisuk , Chalinee Pravarnpat , Akenarong Pipatputthapong , Pongpun Jittham , Paisit Kosum

Introduction & Objectives

Heart failure is one of the major public health concerns and a leading cause of hospitalization and mortality worldwide, including in Thailand. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have demonstrated significant cardiovascular benefits in clinical trials. This study aimed to evaluate the real-world effectiveness of SGLT2i in reducing all-cause mortality and heart failure hospitalization among patients with heart failure at Naresuan University Hospital.

Materials & Methods

This retrospective cohort study included patients newly diagnosed with heart failure at Naresuan University Hospital between January 1, 2019, and December 31, 2023. Patients were divided into those who received SGLT2i and those who did not. The primary outcome was a composite of all-cause mortality and hospitalization for worsening heart failure. Rate ratios were calculated using multilevel mixed-effects Poisson regression, adjusting for baseline characteristics.

Results

A total of 1,378 patients were included (1,080 SGLT2i visits; 5,243 non-SGLT2i visits). The proportion of patients with reduced left ventricular ejection fraction (LVEF ≤ 40%) was higher in the SGLT2i group than the non-SGLT2i group (39.9% vs. 29.4%, p < 0.001). The SGLT2i group also had a higher prevalence of coronary artery disease, myopathy, and chronic kidney disease. Rate of composite outcome (death or heart failure hospitalization) was lower in the SGLT2i group (rate 10.93 per 100 vs. 17.58 per 100). The incidence of the composite outcome was significantly lower in the SGLT2i group compared to the non-SGLT2i group (rate ratio 0.60, 95% CI: 0.42–0.87; p = 0.006). The all-cause mortality rate in the SGLT2i group was markedly lower (rate ratio 0.02, 95% CI: 0.00–0.18; p = 0.001), while heart failure hospitalization showed a favorable trend without reaching statistical significance.

Conclusion

SGLT2i were associated with a significantly lower risk of death and heart failure hospitalization in this real-world cohort of Thai heart failure patients. These findings reinforce the clinical benefits of SGLT2i and support their broader implementation in heart failure management in Thailand.
前言和目的心力衰竭是主要的公共卫生问题之一,也是包括泰国在内的世界范围内住院和死亡的主要原因。钠-葡萄糖共转运蛋白2抑制剂(SGLT2i)在临床试验中显示出显著的心血管益处。本研究旨在评估SGLT2i在降低那累大学医院心力衰竭患者全因死亡率和心力衰竭住院率方面的实际有效性。材料和方法本回顾性队列研究纳入2019年1月1日至2023年12月31日在那累大学医院新诊断为心力衰竭的患者。患者被分为接受SGLT2i治疗和未接受SGLT2i治疗的两组。主要结局是全因死亡率和因心衰恶化而住院的综合结果。采用多水平混合效应泊松回归计算比率,调整基线特征。结果共纳入1378例患者(SGLT2i患者1080例,非SGLT2i患者5243例)。SGLT2i组左室射血分数降低(LVEF≤40%)的患者比例高于非SGLT2i组(39.9% vs 29.4%, p < 0.001)。SGLT2i组也有更高的冠状动脉疾病、肌病和慢性肾脏疾病的患病率。SGLT2i组的综合转归率(死亡或心力衰竭住院)较低(10.93 / 100 vs. 17.58 / 100)。与非SGLT2i组相比,SGLT2i组的综合结局发生率显著降低(比率比0.60,95% CI: 0.42-0.87; p = 0.006)。SGLT2i组全因死亡率明显降低(比率比0.02,95% CI: 0.00-0.18; p = 0.001),心力衰竭住院率呈有利趋势,但无统计学意义。结论:在这个真实世界的泰国心力衰竭患者队列中,sglt2i与较低的死亡和心力衰竭住院风险相关。这些发现加强了SGLT2i的临床益处,并支持其在泰国心力衰竭管理中的更广泛实施。
{"title":"Clinical outcomes of SGLT2 inhibitor use in Thai patients with heart failure: a five-year retrospective cohort study","authors":"Thananan Chanchanayothin ,&nbsp;Chuttikan Klomwong ,&nbsp;Tanawit Saisri ,&nbsp;Suphasin Panudom ,&nbsp;Sakchai Chaiyamahapurk ,&nbsp;Nonthikorn Theerasuwipakorn ,&nbsp;Noppachai Siranart ,&nbsp;Patavee Pajareya ,&nbsp;Nattakorn Songsirisuk ,&nbsp;Chalinee Pravarnpat ,&nbsp;Akenarong Pipatputthapong ,&nbsp;Pongpun Jittham ,&nbsp;Paisit Kosum","doi":"10.1016/j.ijcha.2026.101873","DOIUrl":"10.1016/j.ijcha.2026.101873","url":null,"abstract":"<div><h3>Introduction &amp; Objectives</h3><div>Heart failure is one of the major public health concerns and a leading cause of hospitalization and mortality worldwide, including in Thailand. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have demonstrated significant cardiovascular benefits in clinical trials. This study aimed to evaluate the real-world effectiveness of SGLT2i in reducing all-cause mortality and heart failure hospitalization among patients with heart failure at Naresuan University Hospital.</div></div><div><h3>Materials &amp; Methods</h3><div>This retrospective cohort study included patients newly diagnosed with heart failure at Naresuan University Hospital between January 1, 2019, and December 31, 2023. Patients were divided into those who received SGLT2i and those who did not. The primary outcome was a composite of all-cause mortality and hospitalization for worsening heart failure. Rate ratios were calculated using multilevel mixed-effects Poisson regression, adjusting for baseline characteristics.</div></div><div><h3>Results</h3><div>A total of 1,378 patients were included (1,080 SGLT2i visits; 5,243 non-SGLT2i visits). The proportion of patients with reduced left ventricular ejection fraction (LVEF ≤ 40%) was higher in the SGLT2i group than the non-SGLT2i group (39.9% vs. 29.4%, p &lt; 0.001). The SGLT2i group also had a higher prevalence of coronary artery disease, myopathy, and chronic kidney disease. Rate of composite outcome (death or heart failure hospitalization) was lower in the SGLT2i group (rate 10.93 per 100 vs. 17.58 per 100). The incidence of the composite outcome was significantly lower in the SGLT2i group compared to the non-SGLT2i group (rate ratio 0.60, 95% CI: 0.42–0.87; p = 0.006). The all-cause mortality rate in the SGLT2i group was markedly lower (rate ratio 0.02, 95% CI: 0.00–0.18; p = 0.001), while heart failure hospitalization showed a favorable trend without reaching statistical significance.</div></div><div><h3>Conclusion</h3><div>SGLT2i were associated with a significantly lower risk of death and heart failure hospitalization in this real-world cohort of Thai heart failure patients. These findings reinforce the clinical benefits of SGLT2i and support their broader implementation in heart failure management in Thailand.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101873"},"PeriodicalIF":2.5,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prognostic value of psoas muscle area and pleural effusion in patients undergoing TAVI 腰大肌面积和胸腔积液对TAVI患者预后的价值
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-18 DOI: 10.1016/j.ijcha.2026.101871
Otto Järvinen , Jani Rankinen , Jussi Hernesniemi , Marko Virtanen , Pasi Maaranen , Markku Eskola , Niku Oksala , Juho Tynkkynen

Background

Radiographic markers such as psoas muscle area (PMA) and pleural effusion have been linked to mortality after transcatheter aortic valve implantation (TAVI). We examined their relationship with cause-specific mortality and their incremental prognostic value beyond EuroSCORE II.

Methods

This retrospective study included 1090 consecutive TAVI patients treated at Heart Hospital, Tampere University Hospital between 2008 and 2020. Preoperative CT scans were reviewed for L3-level PMA and pleural effusion (>10 mm thickness). Subdistribution hazard models adjusted for age, sex, BMI, and BSA were used to analyze cause-specific mortality. Incremental prognostic value beyond EuroSCORE II was assessed using time-dependent discrimination indexes (AUC and IDI) and net-reclassification index (NRI) at 3 years.

Results

During a median follow-up of 4.3 years (IQR 3.1–6.0), 54% (n = 590) of patients died: 64% (n = 376) from cardiovascular, 30% (n = 177) from non-cardiovascular, and 6% (n = 37) from unnatural causes. PMA and pleural effusion were associated with cardiovascular mortality (PMA: SDH/1SD 0.88, 95% CI 0.78–0.99, p = 0.037; pleural effusion: SDH 1.73, 95% CI 1.37–2.19, p < 0.001). Combined inclusion of PMA and pleural effusion improved NRI = 0.13 (p = 0.004) and IDI = 0.015 (p = 0.004) of overall mortality prediction compared to EuroSCORE II alone.

Conclusions

Psoas muscle area (PMA) and pleural effusion were independently associated with cardiovascular mortality after TAVI, whereas no significant associations were observed with non-cardiovascular deaths. Combined inclusion of these parameters led to a modest but not clinically meaningful improvement in the EuroSCORE II–based prediction of mortality.
腰大肌面积(PMA)和胸腔积液等影像学指标与经导管主动脉瓣植入术(TAVI)后的死亡率有关。我们研究了它们与病因特异性死亡率的关系,以及它们超出EuroSCORE II的增量预后价值。方法回顾性研究纳入2008年至2020年在坦佩雷大学医院心脏医院连续治疗的1090例TAVI患者。术前复查CT扫描,检查l3级PMA和胸膜积液(厚度为10mm)。对年龄、性别、BMI和BSA进行调整的亚分布风险模型用于分析原因特异性死亡率。使用时间依赖的鉴别指数(AUC和IDI)和3年的净再分类指数(NRI)评估超过EuroSCORE II的增量预后价值。结果在中位随访4.3年(IQR 3.1-6.0)期间,54% (n = 590)的患者死亡:64% (n = 376)死于心血管疾病,30% (n = 177)死于非心血管疾病,6% (n = 37)死于非自然原因。PMA和胸腔积液与心血管死亡率相关(PMA: SDH/1SD 0.88, 95% CI 0.78-0.99, p = 0.037;胸膜积液:SDH 1.73, 95% CI 1.37-2.19, p < 0.001)。与单独使用EuroSCORE II相比,联合纳入PMA和胸腔积液可改善总死亡率预测的NRI = 0.13 (p = 0.004)和IDI = 0.015 (p = 0.004)。结论腰大肌面积(PMA)和胸腔积液与TAVI术后心血管疾病死亡率独立相关,而与非心血管疾病死亡率无显著相关性。这些参数的综合纳入导致基于EuroSCORE ii的死亡率预测有适度但没有临床意义的改善。
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引用次数: 0
Ascending aortic length across a large population presenting to the emergency room, a retrospective cross-sectional study 在急诊室对大量人群的升主动脉长度进行回顾性横断面研究
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-18 DOI: 10.1016/j.ijcha.2026.101874
Thomas Saliba , Gabriella Giandotti Gomar , Olivier Cappeliez , Yasser Alemán-Gómez , Guillaume Fahrni , David Rotzinger

Background

Aortic dissection often occurs at diameters below surgical thresholds, underscoring the need for better predictive markers. Ascending aortic length has emerged as a potential morphologic risk factor, but normal population data are limited. This study aimed to establish normative aortic length values by age and sex and develop a tool to predict dissection risk.

Methods

We retrospectively analyzed 1030 (986 without and 44 with type A dissection) emergency room patients (from 1,445 screened) who underwent ECG-gated thoracic CT angiography between 2019 and 2025, excluding those with prior aortic surgery or disease. Ascending aortic length, from the sinotubular junction to the brachiocephalic trunk, was measured using semi-automated centerline tools. Logistic and LASSO regression models estimated type A dissection probability based on aortic length, age, height, and sex.

Results

Mean ascending aortic length was 70.7 ± 11.6 mm in men and 64.1 ± 11.4 mm in women. Patients with acute type A dissection (n = 44) had significantly longer aortas (men: 93.9 ± 20.5 mm; women: 90.0 ± 18.5 mm; p < 0.001). Aortic length was the strongest independent predictor (OR = 1.13, 95 % CI 1.10–1.17, p < 0.001). A reduced model including only aortic length showed excellent discrimination (AUC = 0.871; sensitivity = 0.773; specificity = 0.867; PPV = 0.206; NPV = 0.988).

Conclusion

Ascending aortic length increases with age and is markedly greater in patients with acute type A dissection. We provide normative reference tables by age and sex and a logistic model for individualized risk estimation of dissection at the time of the exam.
背景:主动脉夹层通常发生在直径低于手术阈值的地方,因此需要更好的预测指标。升主动脉长度已成为潜在的形态学危险因素,但正常人群的数据有限。本研究旨在根据年龄和性别建立主动脉长度的标准值,并开发一种预测夹层风险的工具。方法回顾性分析2019年至2025年期间接受心电图门控胸部CT血管造影的1030例(986例无夹层,44例有A型夹层)急诊患者(筛选1445例),不包括既往主动脉手术或疾病患者。用半自动中心线工具测量从窦管交界处到头臂干的升主动脉长度。Logistic和LASSO回归模型根据主动脉长度、年龄、身高和性别估计A型夹层的概率。结果男性平均升主动脉长度为70.7±11.6 mm,女性平均升主动脉长度为64.1±11.4 mm。急性A型夹层患者(n = 44)主动脉明显较长(男性:93.9±20.5 mm;女性:90.0±18.5 mm; p < 0.001)。主动脉长度是最强的独立预测因子(OR = 1.13, 95% CI 1.10-1.17, p < 0.001)。仅包括主动脉长度的简化模型具有很好的鉴别效果(AUC = 0.871,灵敏度= 0.773,特异性= 0.867,PPV = 0.206, NPV = 0.988)。结论升主动脉长度随年龄增长而增加,急性A型夹层患者升主动脉长度明显增大。我们提供了按年龄和性别划分的规范性参考表,并建立了一个逻辑模型,用于在检查时进行个体化的解剖风险评估。
{"title":"Ascending aortic length across a large population presenting to the emergency room, a retrospective cross-sectional study","authors":"Thomas Saliba ,&nbsp;Gabriella Giandotti Gomar ,&nbsp;Olivier Cappeliez ,&nbsp;Yasser Alemán-Gómez ,&nbsp;Guillaume Fahrni ,&nbsp;David Rotzinger","doi":"10.1016/j.ijcha.2026.101874","DOIUrl":"10.1016/j.ijcha.2026.101874","url":null,"abstract":"<div><h3>Background</h3><div>Aortic dissection often occurs at diameters below surgical thresholds, underscoring the need for better predictive markers. Ascending aortic length has emerged as a potential morphologic risk factor, but normal population data are limited. This study aimed to establish normative aortic length values by age and sex and develop a tool to predict dissection risk.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 1030 (986 without and 44 with type A dissection) emergency room patients (from 1,445 screened) who underwent ECG-gated thoracic CT angiography between 2019 and 2025, excluding those with prior aortic surgery or disease. Ascending aortic length, from the sinotubular junction to the brachiocephalic trunk, was measured using semi-automated centerline tools. Logistic and LASSO regression models estimated type A dissection probability based on aortic length, age, height, and sex.</div></div><div><h3>Results</h3><div>Mean ascending aortic length was 70.7 ± 11.6 mm in men and 64.1 ± 11.4 mm in women. Patients with acute type A dissection (n = 44) had significantly longer aortas (men: 93.9 ± 20.5 mm; women: 90.0 ± 18.5 mm; p &lt; 0.001). Aortic length was the strongest independent predictor (OR = 1.13, 95 % CI 1.10–1.17, p &lt; 0.001). A reduced model including only aortic length showed excellent discrimination (AUC = 0.871; sensitivity = 0.773; specificity = 0.867; PPV = 0.206; NPV = 0.988).</div></div><div><h3>Conclusion</h3><div>Ascending aortic length increases with age and is markedly greater in patients with acute type A dissection. We provide normative reference tables by age and sex and a logistic model for individualized risk estimation of dissection at the time of the exam.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101874"},"PeriodicalIF":2.5,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Echocardiographic reference values in elderly with a focus on octogenarians and older 老年人超声心动图的参考价值,重点是80多岁及以上
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-17 DOI: 10.1016/j.ijcha.2026.101872
Miguel Quintana , Mira Carling , Anders Olofsson , Dag Isaksson , Jenny Fahlen , Elin Kärrman , Fredrik Pihl , Roland Forsberg , Björn Persson , Alen Lovric , Thomas Gustafsson , Karin Bouma

Aims

Most published material on echocardiographic reference values includes individuals up to the age of 60–70, but reference values for older individuals remain scarce. Accurate interpretation of transthoracic echocardiographic reference values in octogenarians and older individuals requires updated values that reflect healthy ageing. This study aims to compare transthoracic echocardiographic reference values of healthy octogenarians and older individuals with those of younger age groups.

Methods and results

A total of 248 individuals were studied. The group was divided into three age categories: sexagenarians, septuagenarians, and octogenarians or older. The participants underwent a standard transthoracic echocardiographic examination according to current guidelines. The main differences between age groups were observed in values related to left ventricular diastolic function. There was a significant difference in some values related to systolic function, such as a significant decrease in mitral annular plane systolic excursion in octogenarians compared to sexagenarians and septuagenarians.

Conclusion

The present study showed statistically significant differences in some echocardiographic parameters primarily reflecting the left ventricular diastolic function. In addition, a significant difference in some values related to systolic function were also found. These findings emphasize the need for age-adapted reference values to improve diagnostic accuracy in elderly.
大多数关于超声心动图参考值的出版材料包括60-70岁的个体,但老年人的参考值仍然很少。准确解释八旬老人和老年人的经胸超声心动图参考值需要更新反映健康老龄化的值。本研究旨在比较健康的八旬老人和老年人与年轻人群的经胸超声心动图参考值。方法与结果对248人进行调查。这些人被分为三个年龄段:60多岁、70多岁和80多岁及以上。根据现行指南,参与者接受了标准的经胸超声心动图检查。年龄组之间的主要差异是观察到与左室舒张功能相关的值。与60岁和70岁老人相比,80岁老人的二尖瓣平面收缩偏移明显减少,与收缩功能相关的一些数值有显著差异。结论本研究显示主要反映左室舒张功能的超声心动图参数差异有统计学意义。此外,与收缩功能相关的一些数值也有显著差异。这些发现强调需要年龄适应的参考值来提高老年人的诊断准确性。
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引用次数: 0
Cardiac conduction abnormalities in myotonic dystrophy type I: The ongoing value of the ECG I型强直性肌营养不良患者的心传导异常:心电图的持续值
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-12 DOI: 10.1016/j.ijcha.2025.101860
Mohammad Abumayyaleh, Tobias Schupp, Michael Behnes, Ibrahim Akin
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引用次数: 0
Advancing cardiac monitoring in adult Duchenne muscular dystrophy: longitudinal insights and real-world challenges 推进心脏监测成人杜氏肌营养不良:纵向见解和现实世界的挑战
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-10 DOI: 10.1016/j.ijcha.2026.101867
Mohammadreza Tabary, Xander H.T. Wehrens
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引用次数: 0
The efficacy of carvedilol in improving cardiac function and survival in patients with anthracycline-induced cardiotoxicity: a comprehensive systematic review and meta-analysis 卡维地洛改善蒽环类药物引起的心脏毒性患者心功能和生存的疗效:一项全面的系统回顾和荟萃分析
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-09 DOI: 10.1016/j.ijcha.2025.101862
Sabahat Ul Ain Munir Abbasi , Riya Bhagwan , Aamna Rehman , Neha Malik , Sanya Ashraf Khaskheli , Najaf Ahmed Rajpar , Rayyan Nabi , Ayesha Amir Basra , Shehdev Meghwar , Raheel Ahmed , Kalpana Singh

Background

Anthracyclines (ANT) are widely used in chemotherapy, but their dose-dependent Cardiotoxicity limits long-term use. Carvedilol, a non-selective beta-blocker, has shown potential as a Cardioprotective agent for patients receiving ANT, though its overall effectiveness remains unclear. This systematic review and meta-analysis aimed to assess the impact of carvedilol on cardiac function and survival in patients with anthracycline-induced Cardiotoxicity.

Methods

We performed a comprehensive search of major electronic databases through March 2025 for studies comparing carvedilol with placebo or no treatment in human subjects with ANT-Induced Cardiotoxicity. Primary outcomes included left ventricular ejection fraction (LVEF), left ventricular systolic dysfunction (LVSD), left ventricular systolic and diastolic diameters (LVsD, LVdD), and mortality. Secondary outcomes included echocardiographic and Doppler parameters. Random-effects models were used to calculate standard mean differences (SMDs) and risk ratios (RR) using RevMan 5.4.

Results

A total of fourteen studies were included, thirteen in the meta-analysis and one in the systematic review only, comprising 1,245 participants (carvedilol: 679; control: 566). Carvedilol significantly preserved LVEF (SMD: 0.33, 95% CI: 0.09, 0.58) and reduced the risk of LVSD (RR: 0.26, 95% CI: 0.11, 0.62). It also decreased systolic (SMD: −0.39, 95% CI: −0.53, −0.26) as well as diastolic ventricular diameter (SMD: −0.19, 95% CI: −0.38, −0.00). However, no significant difference in short-term mortality was observed.

Conclusion

Carvedilol appears to protect cardiac function in patients undergoing ANT therapy, though it does not significantly impact mortality. Further research is needed to determine optimal dosing, timing, and long-term survival benefits.
蒽环类药物(ANT)广泛用于化疗,但其剂量依赖性心脏毒性限制了长期使用。卡维地洛是一种非选择性β受体阻滞剂,已显示出作为接受ANT治疗的患者的心脏保护剂的潜力,尽管其总体有效性尚不清楚。本系统综述和荟萃分析旨在评估卡维地洛对蒽环类药物引起的心脏毒性患者心功能和生存的影响。方法:我们对截至2025年3月的主要电子数据库进行了全面检索,以比较卡维地洛与安慰剂或未治疗的抗氧化剂诱导心脏毒性的人类受试者的研究。主要结局包括左室射血分数(LVEF)、左室收缩功能障碍(LVSD)、左室收缩和舒张直径(LVSD、LVdD)和死亡率。次要结果包括超声心动图和多普勒参数。采用随机效应模型,采用RevMan 5.4计算标准均值差(SMDs)和风险比(RR)。结果共纳入14项研究,其中13项纳入荟萃分析,1项纳入系统评价,共1245名受试者(卡维地洛:679名,对照组:566名)。卡维地洛可显著保护LVEF (SMD: 0.33, 95% CI: 0.09, 0.58),降低LVSD风险(RR: 0.26, 95% CI: 0.11, 0.62)。它还降低了收缩期(SMD: - 0.39, 95% CI: - 0.53, - 0.26)和舒张期心室直径(SMD: - 0.19, 95% CI: - 0.38, - 0.00)。然而,短期死亡率无显著差异。结论卡维地洛可以保护接受ANT治疗的患者的心功能,但对死亡率没有显著影响。需要进一步的研究来确定最佳剂量、时间和长期生存效益。
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引用次数: 0
期刊
IJC Heart and Vasculature
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