IJC Heart and Vasculature最新文献_第4页

Transcatheter or surgical treatment of paravalvular leaks: A meta-analysis of 13 studies and 2003 patients

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-01 DOI: 10.1016/j.ijcha.2024.101583

Riccardo Improta , Gianluca Di Pietro , Yasser Odeh , Arianna Morena , Wael Saade , Fabrizio D’Ascenzo , Massimo Mancone , Fabio Miraldi

Background

Significant paravalvular leak is a rare but serious complication of heart valve replacement, leading to symptomatic heart failure and hemolysis. Due to the paucity of comparative data between surgical and transcatheter paravalvular leak correction, we performed a systematic review and meta-analysis of available studies.

Methods

Studies comparing transcatheter and surgical treatment of paravalvular leak were systematically identified. Short-term all-cause mortality was the primary outcome. Technical and procedural success, 30-day persistence of significant paravalvular leak, length of hospital stay and long-term mortality, persistence of symptoms and paravalvular leak were the main secondary endpoints.

Results

Thirteen studies with 2003 patients were included, treating in most of the cases a mitral prothesis. Transcatheter closure was associated with lower short-term mortality rate (30 days OR 0.28, 95 % CI 0.18–0.42, p < 0.001) compared to surgical treatment. Technical and procedural success did not differ among the two groups. 30-day and long-term rates of persistence of moderate or severe paravalvular leak were higher in the transcatheter group (OR 3.56, 95 % CI 1.49–8.49, p = 0.004 and OR 2.20, 95 % CI 1.27–3.81, p = 0.005 respectively). Long-term death and re-hospitalization events did not differ among the two treatment modalities. The mean difference in days of length of stay was significantly lower in the transcatheter group (mean difference −9.66, 95 % CI −12.37 to −6.94, p < 0.001).

Conclusion

Transcatheter closure of paravalvular leaks is associated with lower short-term mortality rates but higher persistence of moderate-severe paravalvular leak and heart failure symptoms at short and long-term follow-up compared to surgical treatment.

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引用次数: 0

Direct oral anticoagulants in deep vein thrombosis associated with inferior vena cava agenesis: A report of three cases and a systematic review 直接口服抗凝剂治疗伴下腔静脉发育不全的深静脉血栓：附3例报告并系统回顾。

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-01 DOI: 10.1016/j.ijcha.2024.101565

Nicola Osti , Vito Racanelli , Nicola Susca , Nicola Martinelli , Alberto Maino

Background

Inferior vena cava agenesis (IVCA) is a rare vascular abnormality characterised by the absence of one or more segments of the inferior vena cava and represents an underestimated cause of deep vein thrombosis (DVT). Given the very low prevalence of this condition and the lack of clinical trials, there is no consensus about the optimal anticoagulation strategy in IVCA-associated DVT.

Objectives

To investigate efficacy and safety of direct oral anticoagulants (DOACs) in IVCA-associated DVT.

Methods

We described three patients with IVCA-associated DVT followed at our Institution and treated with DOACs. Then, we performed a systematic review of the literature for ICVA-associated DVT treated with DOACs.

Results

In addition to our 3 cases, we found data from 19 publications for a total of 30 patients with IVCA-associated DVT treated with DOACs (24 subjects treated with rivaroxaban, 8 with apixaban, and one with dabigatran). Most patients were males (72.7 %) with a median age at DVT onset of 26.0 years (min–max range 13–64 years). The majority of DVT events were unprovoked (76.0 %). The standard thrombophilia tests were mainly negative. The median follow-up period during DOAC therapy was 1.0 years (min–max range 0–10 years), with one recurrent splanchnic vein thrombosis reported and no haemorrhagic events.

Conclusions

IVCA is a rare cause of DVT, which should be suspected in young adults with unprovoked DVT. Although future studies are needed, available data may support the use of DOACs in IVCA-associated DVT, with a reassuring profile of both efficacy and safety.

背景：下腔静脉发育不全（IVCA）是一种罕见的血管异常，其特征是缺少一个或多个下腔静脉段，是深静脉血栓形成（DVT）的一种被低估的原因。鉴于这种情况的患病率很低且缺乏临床试验，对于ivca相关DVT的最佳抗凝策略尚无共识。目的：探讨直接口服抗凝剂（DOACs）治疗ivca相关性DVT的疗效和安全性。方法：我们描述了3例ivca相关性DVT患者，在我们的机构随访并接受DOACs治疗。然后，我们对使用DOACs治疗icva相关DVT的文献进行了系统回顾。结果：除了我们的3例病例外，我们还发现了来自19篇出版物的数据，共涉及30例使用DOACs治疗的ivca相关DVT患者（24例使用利伐沙班，8例使用阿哌沙班，1例使用达比加群）。大多数患者为男性（72.7%），DVT发病的中位年龄为26.0岁（最小-最大范围13-64岁）。大多数DVT事件是无端的（76.0%）。标准血栓形成试验以阴性为主。DOAC治疗期间的中位随访期为1.0年（最小-最大范围0-10年），报告一例复发性内脏静脉血栓形成，无出血事件。结论：IVCA是一种罕见的导致深静脉血栓形成的原因，在年轻的成人无源性深静脉血栓形成中应予以怀疑。虽然需要进一步的研究，但现有的数据可能支持在ivca相关的DVT中使用DOACs，其疗效和安全性都令人放心。

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引用次数: 0

Expanding the landscape of tricuspid regurgitation with transcatheter tricuspid valve replacement 经导管三尖瓣置换术扩大三尖瓣返流的范围。

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-01 DOI: 10.1016/j.ijcha.2024.101577

Muhammad Adnan Zaman

引用次数: 0

Prognosis of pulmonary hypertension in patients with hypertrophic cardiomyopathy: A multicenter propensity score matching study

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-01 DOI: 10.1016/j.ijcha.2025.101605

Huihui Ma , Fengcheng Xu , Lei Liu , Hong Kong , Rong Luo , Mingjiang Liu , Tianhu Liu , Xiaoping Li

Objectives

Pulmonary hypertension (PH) is known to be associated with increased mortality in patients suffering from left ventricular disease. The aim of this study was to assess the incidence of PH among patients diagnosed with hypertrophic cardiomyopath (HCM) and to evaluate its prognostic significance.

Methods

The study cohort consisted of 2781 patients with HCM. Among them, 226 patients had PH (8.1%), and 2555 patients did not have PH (91.8%). The fourteen demographic and clinical variables were matched between the two groups using a 1:3 propensity score matching (PSM) method. Kaplan–Meier survival curves and Cox proportional hazard regression models were used to evaluate the correlation between PH and mortality. Moreover, a competing risk regression analysis was conducted to assess the competing risk.

Results

Before matching, there were 519 (18.7 %) patients with all-cause mortality, including 292 (10.5 %) patients who experienced cardiovascular mortality and 128 (4.6 %) patients who experienced SCD. There was a significant difference in the Kaplan–Meier survival curves for all-cause mortality (log-rank P < 0.0001), cardiovascular mortality (log-rank P < 0.0001) and SCD (log-rank P = 0.0005). After matching, there were also significant differences in cardiovascular mortality (log-rank P = 0.011) and SCD (log-rank P = 0.042), but only a similar trend was observed for all-cause mortality (log-rank P = 0.052). Cox regression analyses suggested that PH was an independent risk predictor for cardiovascular mortality [HR: 1.666; 95 % CI: 1.145–2.424; P = 0.008].

Conclusion

HCM patients with PH characterized by increased cardiovascular mortality and SCD, as well as a similar trend in all-cause mortality. Moreover, PH is an independent risk factor for cardiovascular mortality.

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引用次数: 0

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-01 DOI: 10.1016/j.ijcha.2025.101600

Dennis Winston T. Nilsen , Reidun Aarsetoey , Volker Poenitz , Thor Ueland , Pål Aukrust , Annika Elisabet Michelsen , Trygve Brugger-Andersen , Harry Staines , Heidi Grundt

Background

α1-antichymotrypsin (SERPINA3), high sensitivity C-reactive protein (hsCRP) and pentraxin 3 (PTX3) are acute phase proteins triggered by inflammation, whereas D-dimer, fibrin monomer and α2-antiplasmin are thrombo-fibrinolytic markers. Sex differences in relation to cardiovascular disease were investigated.

Methods

A total of 871 consecutive patients (61.0 % males; females: 77.3 years, males 69.1 years) were included. Of these, 380 were diagnosed with an acute myocardial infarction (MI). Stepwise Cox regression models, applying normalized continuous log_e/SD values, were fitted for the biomarkers with all-cause mortality, MI and stroke, respectively, and a composite endpoint within 7 years as the dependent variables.

Results

Except for α2-antiplasmin, all biomarkers were significantly associated with all-cause mortality and the combined endpoint in the univariate analysis. None of the inflammatory biomarkers predicted all-cause mortality in females after multivariable adjustment but were significant predictors in males (SERPINA3: HR 1.34 (95 %CI 1.16–1.56), p < 0.0001. hsCRP: HR 1.19 (95 %CI 1.02–1.38), p = 0.027. PTX3: HR 1.22 [95 %CI 1.04–1.44], p = 0.018. The p-value for interaction suggests a sex difference in the prognostic weighting of SERPINA3 (p = 0.015). None of the thrombo-fibrinolytic biomarkers predicted all-cause mortality in males after adjustment, but D-dimer and fibrin monomer were significant predictors of all-cause mortality in females (HR 1.51 [1.29–1.78], p < 0.0001, and HR 1.28 [1.08–1.53] p = 0.005, respectively). A trend towards interaction for D-dimer (p = 0.07) may suggest a sex difference in its prognostic weighting.

Conclusion

SERPINA3, hsCRP and PTX3 predicted long-term all-cause mortality in males but not in females. The opposite relationship was observed for D-dimer and fibrin monomer.

{"title":"Sex-related differences in the prognostic utility of inflammatory and thrombotic cardiovascular risk markers in patients with chest pain of suspected coronary origin","authors":"Dennis Winston T. Nilsen , Reidun Aarsetoey , Volker Poenitz , Thor Ueland , Pål Aukrust , Annika Elisabet Michelsen , Trygve Brugger-Andersen , Harry Staines , Heidi Grundt","doi":"10.1016/j.ijcha.2025.101600","DOIUrl":"10.1016/j.ijcha.2025.101600","url":null,"abstract":"<div><h3>Background</h3><div>α1-antichymotrypsin (SERPINA3), high sensitivity C-reactive protein (hsCRP) and pentraxin 3 (PTX3) are acute phase proteins triggered by inflammation, whereas D-dimer, fibrin monomer and α2-antiplasmin are thrombo-fibrinolytic markers. Sex differences in relation to cardiovascular disease were investigated.</div></div><div><h3>Methods</h3><div>A total of 871 consecutive patients (61.0 % males; females: 77.3 years, males 69.1 years) were included. Of these, 380 were diagnosed with an acute myocardial infarction (MI). Stepwise Cox regression models, applying normalized continuous log<sub>e</sub>/SD values, were fitted for the biomarkers with all-cause mortality, MI and stroke, respectively, and a composite endpoint within 7 years as the dependent variables.</div></div><div><h3>Results</h3><div>Except for α2-antiplasmin, all biomarkers were significantly associated with all-cause mortality and the combined endpoint in the univariate analysis. None of the inflammatory biomarkers predicted all-cause mortality in females after multivariable adjustment but were significant predictors in males (SERPINA3: HR 1.34 (95 %CI 1.16–1.56), p < 0.0001. hsCRP: HR 1.19 (95 %CI 1.02–1.38), p = 0.027. PTX3: HR 1.22 [95 %CI 1.04–1.44], p = 0.018. The p-value for interaction suggests a sex difference in the prognostic weighting of SERPINA3 (p = 0.015). None of the thrombo-fibrinolytic biomarkers predicted all-cause mortality in males after adjustment, but D-dimer and fibrin monomer were significant predictors of all-cause mortality in females (HR 1.51 [1.29–1.78], p < 0.0001, and HR 1.28 [1.08–1.53] p = 0.005, respectively). A trend towards interaction for D-dimer (p = 0.07) may suggest a sex difference in its prognostic weighting.</div></div><div><h3>Conclusion</h3><div>SERPINA3, hsCRP and PTX3 predicted long-term all-cause mortality in males but not in females. The opposite relationship was observed for D-dimer and fibrin monomer.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101600"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

TAVI vs SAVR: The timeless showdown in aortic valve replacement

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-01 DOI: 10.1016/j.ijcha.2025.101608

Massimo Baudo

引用次数: 0

Identification of novel ferroptosis-related biomarkers associated with the oxidative stress pathways in ischemic cardiomyopathy 缺血性心肌病中与氧化应激途径相关的新型铁中毒相关生物标志物的鉴定。

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-01 DOI: 10.1016/j.ijcha.2024.101584

Huilin Liu , Yuan Xu , Yuanmei Liu , XueJun Han , Liping Zhao , Yixuan Liu , Fuchun Zhang , Yicheng Fu

Background

Ferroptosis is a cell death process that depends on iron and reactive oxygen species. It significantly contributes to cardiovascular diseases. However, its exact role in ischemic cardiomyopathy (ICM) is still unclear.

Methods

Using bioinformatics methods, we identified new molecular targets associated with ferroptosis in ICM and conducted various analyses—including correlation analysis, pathway enrichment analysis, protein interaction network construction, and analysis of transcription factor and drug interactions, to reveal the potential mechanisms behind these genes.

Results

We evaluated two independent training sets of ICM, GSE57338 and GSE5406, comprising 203 ICM samples, and validation sets GSE76701 to examine differentially expressed genes (DEGs) related to ferroptosis. After extracting the intersection of the gene sets and ferroptosis-related genes, 53 DEGs were identified. Enrichment analyses showed that the alterations in ferroptosis-related DEGs were mainly enriched in oxidative stress response, and immune-related pathways. Furthermore, 11 hub genes were identified using protein–protein interaction network analysis. The key interactions between 11 hub genes were more pronounced in protein localization during ICM development. In addition, we construct a hub gene and transcription factor interaction network and a small molecule drug-gene interaction network. We found that among these hub genes, the N-acetylneuraminate outer membrane channel(NANC) gene is positively correlated with most of the small-molecule drugs used to treat ICM, and its high expression might increase resistance.

Conclusions

Ferroptosis exists in ICM and and is associated with oxidative stress. This association suggests that ferroptosis may facilitate the progression of ICM.

背景：铁变态反应是一种依赖于铁和活性氧的细胞死亡过程。它是心血管疾病的重要诱因。然而，它在缺血性心肌病（ICM）中的确切作用仍不清楚：利用生物信息学方法，我们发现了 ICM 中与铁突变相关的新分子靶点，并进行了各种分析，包括相关性分析、通路富集分析、蛋白质相互作用网络构建以及转录因子和药物相互作用分析，以揭示这些基因背后的潜在机制：我们评估了由203个ICM样本组成的两个独立的ICM训练集GSE57338和GSE5406，以及验证集GSE76701，以研究与铁中毒相关的差异表达基因（DEGs）。提取基因集和铁蛋白沉积相关基因的交叉点后，发现了 53 个 DEGs。富集分析表明，与铁变态反应相关的 DEGs 的改变主要富集在氧化应激反应和免疫相关通路中。此外，通过蛋白质-蛋白质相互作用网络分析，还发现了11个枢纽基因。11个枢纽基因之间的关键相互作用在ICM发育过程中的蛋白定位中更为明显。此外，我们还构建了枢纽基因与转录因子相互作用网络和小分子药物-基因相互作用网络。我们发现，在这些枢纽基因中，N-乙酰神经氨酸外膜通道（NANC）基因与大多数治疗 ICM 的小分子药物呈正相关，其高表达可能会增加耐药性：结论：ICM 中存在铁变态反应，且与氧化应激有关。这种关联表明，铁蛋白沉积可能会促进 ICM 的进展。

{"title":"Identification of novel ferroptosis-related biomarkers associated with the oxidative stress pathways in ischemic cardiomyopathy","authors":"Huilin Liu , Yuan Xu , Yuanmei Liu , XueJun Han , Liping Zhao , Yixuan Liu , Fuchun Zhang , Yicheng Fu","doi":"10.1016/j.ijcha.2024.101584","DOIUrl":"10.1016/j.ijcha.2024.101584","url":null,"abstract":"<div><h3>Background</h3><div>Ferroptosis is a cell death process that depends on iron and reactive oxygen species. It significantly contributes to cardiovascular diseases. However, its exact role in ischemic cardiomyopathy (ICM) is still unclear.</div></div><div><h3>Methods</h3><div>Using bioinformatics methods, we identified new molecular targets associated with ferroptosis in ICM and conducted various analyses—including correlation analysis, pathway enrichment analysis, protein interaction network construction, and analysis of transcription factor and drug interactions, to reveal the potential mechanisms behind these genes.</div></div><div><h3>Results</h3><div>We evaluated two independent training sets of ICM, GSE57338 and GSE5406, comprising 203 ICM samples, and validation sets GSE76701 to examine differentially expressed genes (<em>DEGs</em>) related to ferroptosis. After extracting the intersection of the gene sets and ferroptosis-related genes, 53 <em>DEGs</em> were identified. Enrichment analyses showed that the alterations in ferroptosis-related <em>DEGs</em> were mainly enriched in oxidative stress response, and immune-related pathways. Furthermore, 11 hub genes were identified using protein–protein interaction network analysis. The key interactions between 11 hub genes were more pronounced in protein localization during ICM development. In addition, we construct a hub gene and transcription factor interaction network and a small molecule drug-gene interaction network. We found that among these hub genes, the N-acetylneuraminate outer membrane channel(<em>NANC)</em> gene is positively correlated with most of the small-molecule drugs used to treat ICM, and its high expression might increase resistance.</div></div><div><h3>Conclusions</h3><div>Ferroptosis exists in ICM and and is associated with oxidative stress. This association suggests that ferroptosis may facilitate the progression of ICM.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101584"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Functional myocardial assessment in cine cardiac computerized tomographic angiography using echocardiographic feature-tracking software in patients with and without significant coronary disease 应用超声心动图特征跟踪软件对有或无明显冠心病患者进行心脏计算机断层血管造影的心肌功能评估。

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-01 DOI: 10.1016/j.ijcha.2024.101586

Adi Hertz , Michael Jerdev , Liza Grosman-Rimon , Itiel Ben-Zakai , Jordan Rimon , Offer Amir , Gabby Elbaz Greener , Shemy Carasso

Introduction

Cardiac computerized tomographic angiography (CCTA) is perceived as a non-invasive tool for assessment of coronary vessel anatomy. Feature tracking echocardiography has recently emerged as a tool for assessment of regional and global left ventricular function. We aimed to explore the applicability of echocardiographic strain on CCTA cine clips and assess whether global and regional strain parameters are associated with the extent of coronary stenosis.

Methods

CCTA studies of 61 consecutive patients were reconstructed to yield cine images in classic echocardiographic long and short views. Siemens Velocity Vector Imaging (VVI) software was applied to generate strain and displacement results. Volumetric and mechanics parameters were compared among patients with no or non-significant coronary artery disease (CAD) and patients with significant CAD. Finally, a comparison of the degree of coronary stenosis to regional segmental strain was performed.

Results

Myocardial mechanics parameters could be generated in 60 cases. Ejection fraction (EF) and left ventricular end diastolic volume (LVEDV) were within the normal range in both groups. VVI values were lower in the CAD group (VVI LVEF 59 ± 6 vs. 50 ± 11, p = 0.0002). Global longitudinal and global circumferential strain both were significantly lower in this group. Regional segmental strain was lower in segments affected by coronary stenosis in comparison to unaffected segments.

Conclusion

While CT segmentation derived LVEF did not differ among groups, patients with significant coronary stenosis had reduced longitudinal and circumferential contraction. This suggests that application of VVI to CCTA cine clips tracking may help to differentiate significant and non-significant coronary stenosis, adding functional value to anatomic findings in CCTA.

心脏计算机断层血管造影（CCTA）被认为是一种评估冠状血管解剖的无创工具。特征跟踪超声心动图最近成为一种评估局部和全局左心室功能的工具。我们的目的是探讨超声心动图应变对CCTA电影片段的适用性，并评估整体和区域应变参数是否与冠状动脉狭窄程度相关。方法：对61例连续患者的CCTA研究进行重建，获得经典超声心动图长视图和短视图的电影图像。采用西门子速度矢量成像（VVI）软件生成应变和位移结果。比较无或非显著冠心病（CAD）患者和显著冠心病患者的体积和力学参数。最后，对冠状动脉狭窄程度与局部节段性应变进行比较。结果：60例患者均可获得心肌力学参数。两组患者射血分数（EF）和左室舒张末期容积（LVEDV）均在正常范围内。CAD组VVI值较低（VVI LVEF 59±6比50±11，p = 0.0002）。整体纵向应变和整体周向应变均显著降低。受冠状动脉狭窄影响的节段与未受影响的节段相比，区域节段应变较低。结论：CT分割得到的LVEF在各组间无差异，但冠状动脉狭窄明显患者的纵向和周向收缩均减少。这表明将VVI应用于CCTA电影片段跟踪可能有助于区分显著和非显著冠状动脉狭窄，增加CCTA解剖结果的功能价值。

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引用次数: 0

Fully automated coronary artery calcium score and risk categorization from chest CT using deep learning and multiorgan segmentation: A validation study from National Lung Screening Trial (NLST)

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-01 DOI: 10.1016/j.ijcha.2024.101593

Sudhir Rathore , Ashish Gautam , Prashant Raghav , Vijay Subramaniam , Vikash Gupta , Maanya Rathore , Ananmay Rathore , Samir Rathore , Srikanth Iyengar

Background

The National Lung Screening Trial (NLST) has shown that screening with low dose CT in high-risk population was associated with reduction in lung cancer mortality. These patients are also at high risk of coronary artery disease, and we used deep learning model to automatically detect, quantify and perform risk categorisation of coronary artery calcification score (CACS) from non-ECG gated Chest CT scans.

Materials and methods

Automated calcium quantification was performed using a neural network based on Mask regions with convolutional neural networks (R-CNN) for multiorgan segmentation. Manual evaluation of calcium was carried out using proprietary software. This study used 80 patients to train the segmentation model and randomly selected 1442 patients were used for the validation of the algorithm. We compared the model generated results with Ground Truth.

Results

Automatic cardiac and aortic segmentation model worked well (Mean Dice score: 0.91). Cohen’s kappa coefficient between the reference actual and the interclass computed predictive categories on the test set is 0.72 (95 % CI: 0.61–0.83). Our method correctly classifies the risk group in 78.8 % of the cases and classifies the subjects in the same group. F-score is measured as 0.78; 0.71; 0.81; 0.82; 0.92 in calcium score categories 0(CS:0), I (1–99), II (100–400), III (400–1000), IV (>1000), respectively. 79 % of the predictive scores lie in the same categories, 20 % of the predictive scores are one category up or down, and only 1.2 % patients were more than one category off. For the presence/absence of coronary artery calcifications, our deep learning model achieved a sensitivity of 90 % and a specificity of 94 %.

Conclusion

Fully automated model shows good correlation compared with reference standards. Automating the process could improve diagnostic ability, risk categorization, facilitate primary prevention intervention, improve morbidity and mortality, and decrease healthcare costs.

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引用次数: 0

Clinical Characteristics and Outcomes of Takotsubo Syndrome Patients with Gastrointestinal Diseases: A Systematic Review

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-01 DOI: 10.1016/j.ijcha.2025.101620

Jiaming Guo , Yiran Zhang , Xiaoyu Jiang , Huinan Wang , Yaohan Guo , Yuxin Fan , Cai Peng , Catherine Teng , Ao Shi , Xiaojia Lu , Jianjun Ma , Man Dong , Pengyang Li

Background

Takotsubo syndrome (TTS) is identified by its acute and transient impairment of left ventricular systolic function. Although recent research has highlighted occurrences of TTS among individuals with gastrointestinal diseases (GI diseases), comprehensive and systematic investigations focusing on this patient demographic are still scarce.

Methods

This retrospective study analyzed case reports and series that documented an association between gastrointestinal diseases (GI diseases) and Takotsubo syndrome (TTS). We conducted comprehensive searches across PubMed, Embase, and the Cochrane Database to identify relevant cases.

Results

In patients with gastrointestinal-induced Takotsubo syndrome (GI-TTS), the primary reasons for admission were pancreatitis (15.48 %), liver failure (10.71 %), bowel obstruction (5.95 %) and liver cirrhosis (5.95 %). It is noteworthy that the main triggers for Takotsubo syndrome are surgeries related to gastrointestinal diseases (29.76 %), including liver transplantation (15.48 %) and cholecystectomy (2.38 %). Dyspnea (45.71 %) was the most common symptom, followed by abdominal pain (35.71 %) and chest pain (34.29 %). The apical type was the most frequent TTS variant (81.25 %). Compared with the All-TTS cohort, GI-TTS patients were younger, and had a lower proportion of women (69.05 % vs. 89.77 %, P < 0.001). GI-TTS patients had higher ventilation use and lower usage of β-blockers, ACEI/ARBs, aspirin, and statins, while catecholamine use was more prevalent.

Conclusions

The study underscores the potential of gastrointestinal diseases and their treatments to trigger TTS, often presenting atypical clinical features compared to TTS of all types. Given these differences, an elevated level of clinical vigilance is imperative for the timely diagnosis of TTS in patients with gastrointestinal conditions.

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引用次数: 0