IJC Heart and Vasculature最新文献

{"title":"Coronary artery calcium on lung cancer screening-CT: An opportunity to optimize cardiovascular disease risk reduction","authors":"Bethlehem Mengesha ,&nbsp;Keren Mbondo Kasuku ,&nbsp;Toby David Small ,&nbsp;Marcella Cabral Caires ,&nbsp;Habibat Garuba ,&nbsp;Angeline Law ,&nbsp;Christopher Johnson ,&nbsp;David Ian Paterson ,&nbsp;Carole Dennie ,&nbsp;Elena Pena ,&nbsp;Benjamin JW Chow ,&nbsp;Gary R Small","doi":"10.1016/j.ijcha.2025.101826","DOIUrl":"10.1016/j.ijcha.2025.101826","url":null,"abstract":"<div><h3>Background</h3><div>In lung cancer screening trials, mortality from cardiovascular disease occurs at similar rates to lung cancer deaths. Survival following lung cancer screening could be optimized if atherosclerosis prevention was targeted. Thus, we sought to determine whether there was potential for improvement in rates of cardiovascular risk reduction therapy based upon coronary artery calcium and cardiovascular risk assessment.</div></div><div><h3>Methods</h3><div>Clinical lung cancer screening-CT reports, lipid lowering therapy and clinical demographics were retrieved from the electronic medical record in the first consecutive 1486 cases without known coronary artery disease from the Ontario High Risk Lung Cancer Screening Pilot program. Lung cancer screening CT images were reviewed for presence and extent of coronary artery calcium.</div></div><div><h3>Results</h3><div>Coronary artery calcium was detected in 83 % and was reported in 63 %. Lipid lowering was prescribed in 60 % of cases whose coronary artery calcium was reported versus 45 % of cases when coronary artery calcium was unreported (p &lt; 0.001). On multivariable analysis, increased Framingham risk score (OR 2.31 95 % CI 1.73–2.31, p &lt; 0.001) and reported coronary artery calcium (OR 1.53 95 % CI 1.22–1.92, p &lt; 0.001) were associated with lipid lowering therapy. Additional cardiovascular risk lowering could be achieved in 21 % using coronary artery calcium and in 44 % with further consideration of clinical risk.</div></div><div><h3>Conclusions</h3><div>In lung cancer screened patients, cardiovascular risk reduction could be optimized significantly by the opportunistic use of coronary artery calcium and clinical assessment. Appropriate cardiovascular risk reduction could attenuate the high prevalence of cardiovascular deaths in these individuals and improve overall survival.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101826"},"PeriodicalIF":2.5,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145362288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of complete revascularization with safety and outcomes in elderly patients with multi-vessel coronary artery disease: a systematic review and meta-analysis","authors":"David T. Zhang ,&nbsp;Matt Raven ,&nbsp;Manasa Dondapati ,&nbsp;Ravi Masson ,&nbsp;Puja B. Parikh ,&nbsp;Travis Bench ,&nbsp;John P. Reilly ,&nbsp;Michael Tao","doi":"10.1016/j.ijcha.2025.101825","DOIUrl":"10.1016/j.ijcha.2025.101825","url":null,"abstract":"<div><h3>Background</h3><div>The utility of complete revascularization has been well defined in young patients with acute coronary syndrome (ACS) and multivessel coronary artery disease (CAD). However, the clinical benefit in elderly patients remains unclear with current literature has yielded conflicting results. This meta-analysis aims to evaluate the association of complete versus culprit-only coronary revascularization with mortality in elderly patients with multivessel CAD.</div></div><div><h3>Methods</h3><div>A literature search was conducted for studies reporting on outcomes after complete versus culprit-only revascularization in elderly patients with multivessel CAD presenting with ACS. The primary endpoint was all-cause mortality. The main secondary endpoint was cardiovascular (CV) mortality. The search included the following databases: PubMed, EMBASE, and Web of Science. The search was not restricted to time or publication status.</div></div><div><h3>Results</h3><div>14 studies with 11,994 elderly patients (7,236 with culprit-only, 4,758 with complete revascularization) met inclusion criteria. Mean follow-up duration was 29.0 months (range 12–56 months), mean age was 79.5 years old, 56.9% of patients were men, and mean left ventricular ejection fraction was 54.3%. Patients who underwent complete revascularization had significantly lower all-cause and CV mortality compared to culprit-only revascularization (OR 1.75, 95% CI 1.40–2.18; p &lt; 0.001; OR 1.75, 95% CI 1.14–2.68; p = 0.01). Subgroup analysis demonstrated this association to be statistically significant for studies with cohorts presenting with non-ST segment elevation myocardial infarction (NSTEMI) and mixed cohorts that included NSTEMI and ST segment elevation myocardial infarction (STEMI) patients. However, there was no significant difference in risk of all-cause mortality with complete versus culprit-only revascularization in studies of only STEMI patients (OR 1.03, 95% CI 0.61–1.72; p = 0.92).</div></div><div><h3>Conclusion</h3><div>Complete coronary revascularization is associated with lower risk of all-cause and CV mortality in elderly patients with multivessel CAD presenting with NSTEMI. However, there does not appear to be a difference in outcomes in patients presenting with STEMI.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101825"},"PeriodicalIF":2.5,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145362285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic endovascular aortic repair for traumatic and non-traumatic rupture of the descending thoracic aorta: A 15-year single-centre experience","authors":"Ricarda Berkenheide ,&nbsp;Rolf Alexander Jánosi ,&nbsp;Fadi Al-Rashid ,&nbsp;Daniel Messiha ,&nbsp;Konstantinos Tsagakis ,&nbsp;Christos Rammos ,&nbsp;Sharaf-Eldin Shehada ,&nbsp;Payam Akhyari ,&nbsp;Thomas Schlosser ,&nbsp;Tienush Rassaf ,&nbsp;Julia Lortz","doi":"10.1016/j.ijcha.2025.101818","DOIUrl":"10.1016/j.ijcha.2025.101818","url":null,"abstract":"<div><h3>Background</h3><div>Ruptures of the descending thoracic aorta are life-threatening emergencies with traumatic and non-traumatic causes. Thoracic endovascular aortic repair (TEVAR) has become a key treatment, but long-term outcome data remain limited. This study aimed to review our experience with TEVAR in patients with traumatic or non-traumatic rupture and identify factors associated with post-TEVAR survival.</div></div><div><h3>Methods</h3><div>Between 2001 and 2016, 56 patients (21 with traumatic rupture and 35 with non-traumatic rupture) underwent TEVAR at the West-German Heart and Vascular Center Essen, Germany. Data examined included demographics, comorbidities, biomarker levels, imaging results, intervention details, complications, and outcomes (30 days and follow-up).</div></div><div><h3>Results</h3><div>Patients with non-traumatic rupture were significantly older and had more cardiovascular comorbidities. Patients with traumatic rupture presented more frequently with hemodynamic shock and mediastinal hematoma (47 %). Left subclavian artery coverage was more common in traumatic rupture (57.1 % vs. 18.2 %). Long-term aortic complications were more frequent in non-traumatic rupture (33.3 % vs. 0 %). Patients with traumatic rupture showed significantly longer survival. The overall 30-day mortality was 14.3 % (4.7 % in traumatic rupture patients vs. 20 % in non-traumatic rupture patients) and long-term mortality was 64.5 % (33.3 % in traumatic rupture patients vs. 84.2 % in non-traumatic rupture patients). Age, hypertension, complications, and the aetiology of aortic rupture significantly affected survival.</div></div><div><h3>Conclusion</h3><div>Patients with traumatic aortic rupture are younger, have healthier vessels, and show better outcomes after TEVAR. This may allow longer follow-up intervals in selected cases, while closer monitoring remains necessary for non-traumatic ruptures.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101818"},"PeriodicalIF":2.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145320617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individualized paced deep breathing training with autonomic nervous function as rehab targets in patients with chronic heart failure: a randomized clinical trial","authors":"Xiaoling Liu ,&nbsp;Ziwei Shan ,&nbsp;Ting Shen ,&nbsp;Megan Lo ,&nbsp;Lin Luo ,&nbsp;Qifan Sun ,&nbsp;Lemin Wang ,&nbsp;Guanghe Li ,&nbsp;Yumei Jiang ,&nbsp;Dejie Li ,&nbsp;Mengyi Zhan ,&nbsp;Liang Zheng ,&nbsp;Jiankang Wu ,&nbsp;Yuqin Shen","doi":"10.1016/j.ijcha.2025.101800","DOIUrl":"10.1016/j.ijcha.2025.101800","url":null,"abstract":"<div><h3>Background</h3><div>The autonomic imbalance and low vagal tone are common characteristic among patients with chronic heart failure (CHF). It is hypothesized that CHF rehabilitation programs targeting autonomic nerves system (ANS) function may offer greater efficacy for CHF management. This trial represents the first attempt to investigate such an approach.</div></div><div><h3>Methods</h3><div>This is a randomized controlled trial aimed to examine the effectiveness of individualized paced deep breathing training (IBT) in CHF patients, with ANS measures as rehabilitation targets. Patients in the IBT group received an additional 4-week program of IBT alongside their standard rehabilitation care. The cardiopulmonary resonance index (CRI), 6-Minute Walking Distance (6MWD) and the Minnesota Quality of Life Score Questionnaire (MLHFQ) were assessed at baseline (T1) and after 4 weeks (T2).</div></div><div><h3>Results</h3><div>All 38 participants completed the trial successfully. Participants in the IBT group showed significant improvements in CRI, including enhancements in respiratory stability (RS), cardiopulmonary resonance amplitude (CRA), cardiopulmonary resonance factor (CRF), cardiopulmonary coupling coefficient (CPC), and the Spearman’s Rank Correlation Coefficient between Respiratory Rate and Heart Rate (CRS). Further, improvements in both 6MWD and MLHFQ scores were observed. [Multiple linear regression analysis results showed correlations between RS and white blood cell (r = 0.924), CRF and procalcitonin (r = 0.733) and serum creatinine (r = 0.494), as well as CRS and glycosylated hemoglobin (r = 0.819)].</div></div><div><h3>Conclusions</h3><div>These findings demonstrate that IBT is a feasible and effective rehabilitation approach for CHF patients with ANS measures as target. The IBT program here also showed therapist efficiency and good patients compliance.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101800"},"PeriodicalIF":2.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145320620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified body mass index as a novel prognostic indicator of in-hospital mortality after off-pump coronary artery bypass grafting: A nationwide multicenter cohort study","authors":"Shipan Wang ,&nbsp;Yilin Li ,&nbsp;Hao Han ,&nbsp;Tianxu Han ,&nbsp;Zhiran Yang ,&nbsp;Youjin Li ,&nbsp;Haiping Yang ,&nbsp;Hongli Li ,&nbsp;Gang Liu ,&nbsp;Minjia Zhu ,&nbsp;Jian Huang ,&nbsp;Qingwu Zhao ,&nbsp;Jihong Liu ,&nbsp;Haibin Li ,&nbsp;Shuaitong Zhang ,&nbsp;Yuan Xue ,&nbsp;Hongjia Zhang ,&nbsp;Haiyang Li","doi":"10.1016/j.ijcha.2025.101823","DOIUrl":"10.1016/j.ijcha.2025.101823","url":null,"abstract":"<div><h3>Background</h3><div>Malnutrition is a prevalent yet underrecognized comorbidity in coronary artery bypass grafting (CABG) patients. Modified BMI (mBMI), defined as albumin × BMI, has been proposed as a more accurate indicator of nutritional risk. This study examined the association between preoperative mBMI and in-hospital outcomes following Off-pump CABG (OPCABG).</div></div><div><h3>Methods</h3><div>This retrospective cohort study included patients with coronary artery disease who underwent isolated OPCABG at eight cardiac centers. Patients were stratified into tertiles based on preoperative mBMI values. The primary endpoint was in-hospital mortality. Logistic regression and restricted cubic spline models were used to evaluate the association between mBMI and outcomes. Subgroup analyses were performed based on clinical characteristics including sex, age, renal function, and comorbidity burden.</div></div><div><h3>Results</h3><div>Among 6,667 patients, the lowest mBMI tertile had higher in-hospital mortality (2.52 % vs 1.53 % vs 1.17 %), cerebral infarction (2.48 % vs 2.34 % vs 1.39 %), and dialysis rates (1.04 % vs 0.54 % vs 0.36 %) compared to higher tertiles (all P &lt; 0.05). Restricted cubic spline analysis revealed an inverse association between mBMI and the odds of in-hospital mortality, with the lowest risk observed around mBMI 1300–1350. Subgroup analyses demonstrated this relationship was particularly significant among females, patients with eGFR ≤ 90, and those with ASA score &gt; 3 (P for association = 0.023, 0.013, and 0.049, respectively).</div></div><div><h3>Conclusion</h3><div>Lower mBMI is associated with an increased risk of in-hospital mortality and multiple adverse outcomes in patients undergoing OPCABG, particularly among females and those with renal impairment or systemic comorbidities.</div><div><strong>Trial registration:</strong> Chinese Clinical Trial Registry: Chictr2400085741.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101823"},"PeriodicalIF":2.5,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145320618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peri-procedural respiratory complications in patients undergoing pulmonary vein isolation under procedural sedation and analgesia: Incidence and predictive factors","authors":"Marloes Homberg ,&nbsp;Konstanze Betz ,&nbsp;Sander M.J. van Kuijk ,&nbsp;Justin Luermans ,&nbsp;E.A. Joosten ,&nbsp;Wolfgang Buhre ,&nbsp;Ulrich Schotten ,&nbsp;Kevin Vernooy ,&nbsp;Dominik Linz ,&nbsp;Esther Bouman","doi":"10.1016/j.ijcha.2025.101822","DOIUrl":"10.1016/j.ijcha.2025.101822","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Catheter ablation (CA) in patients with atrial fibrillation (AF) can be performed under procedural sedation and analgesia (PSA). Risk factors for respiratory complications during PSA are unclear. We aimed to determine the incidence and severity of respiratory complications during PSA and identify predictive factors for development of per-procedural respiratory complications.</div></div><div><h3>Methods</h3><div>Patients with AF receiving PSA in the MUMC⁺ for CA were included. Respiratory complications were defined as the need of an oral/nasal airway, a non-rebreathing mask, high flow oxygen, a hypoxemic event or conversion to general anaesthesia.</div></div><div><h3>Results</h3><div>In total 232 procedures (42.2 % cryoballoon ablation; 57.3 % RF ablation) were performed. Most patients were male (62.1 %), with a mean age of 64 ± 9.3 (mean ± SD), an activity level ≥ 4 METS (94.8 %) and paroxysmal AF (68.5 %). Respiratory complications occurred in 42.2 %. A multiple logistic regression model including sedation duration, age &gt; 50 years, neck circumference &gt; 40 cm, visceral fat percentage, self-reported tiredness, apnoea hypopnoea index (AHI), medical background of diagnosed sleep apnoea (OSAS) and chronic obstructive pulmonary disease (COPD) identified patients at risk with an AUROC 0.72, 95 % CI: 0.65–0.78.</div></div><div><h3>Conclusion</h3><div>In patients with AF undergoing CA under PSA, per-procedural respiratory complications occur in 42.2 % of the cases. Duration of the PSA, a neck circumference &gt; 40 cm, visceral fat percentage, tiredness, AHI, OSAS and COPD may help to identify patients at risk for per-procedural respiratory complications. Although age &gt; 50 years is a recognized risk factor, this cut-off had limited discriminative value in our cohort, as most patients were older than 50.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101822"},"PeriodicalIF":2.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145320619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent highlights from the International Journal of Cardiology Heart & Vasculature: Stroke prevention and rhythm control in patients with atrial fibrillation","authors":"Dominik Linz ,&nbsp;Dobromir Dobrev","doi":"10.1016/j.ijcha.2025.101816","DOIUrl":"10.1016/j.ijcha.2025.101816","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101816"},"PeriodicalIF":2.5,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of miR-21-5p in the pathogenesis of abdominal aortic aneurysm regarding the Th17 pathway","authors":"Dorota Studzińska ,&nbsp;Sabina Lichołai ,&nbsp;Kamil Polok ,&nbsp;Hanna Plutecka ,&nbsp;Piotr Kica ,&nbsp;Piotr Grazda ,&nbsp;Maciej Chwała ,&nbsp;Marek Sanak ,&nbsp;Wojciech Szczeklik","doi":"10.1016/j.ijcha.2025.101821","DOIUrl":"10.1016/j.ijcha.2025.101821","url":null,"abstract":"<div><h3>Background and aims</h3><div>The interplay between Th17-related immune activity and miRNA-driven regulation in abdominal aortic aneurysm (AAA) pathogenesis remains poorly understood. In this prospective study, we aimed to assess the potential role of miR-21-5p corresponding to the Th17 pathway disturbances in the development of AAA.</div></div><div><h3>Methods</h3><div>Biological samples were collected from patients with true infrarenal AAA, undergoing elective open abdominal aortic surgery, and patients with peripheral arterial disease (PAD) without concomitant aneurysms on the day of hospital admission for surgery. A fragment of aneurysmal abdominal aortic tissue was collected from patients intraoperatively. Total RNA was extracted from the samples, and the expression level of miR-21-5p and selected markers associated with Th17 pathway were assessed using quantitative real-time PCR (RT-qPCR) and Luminex assays, respectively. Moreover, we performed an in vitro model using human endothelial cells, transfected with a synthetic miR-21-5p mimic.</div></div><div><h3>Results</h3><div>We included 60 patients (30 in the study group and 30 in the control group, selected based on the propensity score matching method). Circulating miR-21-5p levels were significantly higher in AAA patients compared to controls. miR-21-5p downregulates genes involved in endothelial development, regulation of vascular permeability, or endothelial cell response to growth factors. We demonstrated that the Th17 circulating mediators were higher among AAA patients compared to controls, and were higher in the middle part of the aneurysmal aorta when compared to its upper pole.</div></div><div><h3>Conclusion</h3><div>Our study showed that, regarding AAA pathogenesis, endothelial dysfunction followed by inflammation could be mediated by an increased level of miR-21-5p.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101821"},"PeriodicalIF":2.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased dipeptidyl peptidase 4 in patients with concomitant transthyretin cardiac amyloidosis and severe aortic stenosis","authors":"Margrethe Flesvig Holt ,&nbsp;Annika E. Michelsen ,&nbsp;August Flø ,&nbsp;Kristoffer Russell ,&nbsp;Jan Otto Beitnes ,&nbsp;Sophie Foss Kløve ,&nbsp;Anders Hodt ,&nbsp;Lars Gullestad ,&nbsp;Pål Aukrust ,&nbsp;Einar Gude ,&nbsp;Kaspar Broch ,&nbsp;Thor Ueland","doi":"10.1016/j.ijcha.2025.101820","DOIUrl":"10.1016/j.ijcha.2025.101820","url":null,"abstract":"<div><h3>Background</h3><div>Due to overlapping symptoms and signs, it can be challenging to diagnose transthyretin amyloid cardiomyopathy (ATTR-CM) in the setting of concomitant aortic stenosis. Biomarkers may discriminate between heart failure with ATTR-CM and heart failure without ATTR-CM, but it is not known if these markers can differentiate between AS with and AS without concomitant ATTR-CM.</div></div><div><h3>Methods</h3><div>In 9 patients with ATTR-CM and AS, 161 patients with lone AS, and 23 healthy controls, we measured 8 plasma proteins previously identified by proteomic analysis as potential candidates for diagnosing ATTR-CM. We assessed differences between groups and association with indices of heart failure and AS severity.</div></div><div><h3>Results</h3><div>Plasma levels of dipeptidyl peptidase 4 (DPP4) were significantly higher in patients with AS and ATTR-CM than in patients with lone AS and in healthy controls. Lower levels of DPP4 were also associated with worse left ventricular function, higher New York Heart Association functional class, and low-flow, low-gradient aortic stenosis.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that DPP4 may be a marker of ATTR-CM in patients with severe AS. In all AS patients, those with and without coexisting ATTR-CM, high DPP4 levels were asociated with better cardiac function.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101820"},"PeriodicalIF":2.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left atrial appendage thrombi despite oral anticoagulation in transthyretin amyloid cardiomyopathy patients undergoing electrical cardioversion for atrial fibrillation or − flutter","authors":"Michael Poledniczek ,&nbsp;Christina Kronberger ,&nbsp;Bernhard Gregshammer,&nbsp;Luca List,&nbsp;Robin Willixhofer,&nbsp;Nikita Ermolaev,&nbsp;Franz Duca,&nbsp;René Rettl,&nbsp;Christina Binder,&nbsp;Luciana Camuz Ligios,&nbsp;Christian Nitsche,&nbsp;Mahshid Eslami,&nbsp;Senta Graf,&nbsp;Stefan Kastl,&nbsp;Johannes Kastner,&nbsp;Roza Badr Eslam,&nbsp;Christian Hengstenberg,&nbsp;Andreas Kammerlander,&nbsp;Jutta Bergler-Klein","doi":"10.1016/j.ijcha.2025.101790","DOIUrl":"10.1016/j.ijcha.2025.101790","url":null,"abstract":"<div><h3>Background</h3><div>Patients with cardiac amyloidosis undergoing direct current electrical cardioversion (DCCV) are at risk of left atrial appendage thrombus (LAAT). We investigated LAAT formation rates, success rates, and long-term recurrence rates in transthyretin amyloid cardiomyopathy (ATTR-CM) patients.</div></div><div><h3>Methods</h3><div>ATTR-CM patients scheduled to undergo DCCV were included in the study. LAAT exclusion was performed utilizing transesophageal echocardiography or computed tomography.</div></div><div><h3>Results</h3><div>A total of 62 (1.35 per patient) DCCVs were recorded among 46 patients (77 ± 6.5 years, 89 % male) with ATTR-CM. In 39 DCCVs, LAAT exclusion was performed (62.9 %). In total, 10 DCCVs (16.1 %) were canceled due to (I) spontaneous conversion to sinus rhythm (n = 2, 5.1 %) or (II) definitive/suspected LAAT (n = 8, 20.5 %). Of these, five patients with LAAT had been receiving sufficient doses of oral anticoagulants for more than three weeks prior to DCCV. The immediate success rate was 92.3 %, and 3-month rhythm control was achieved in 27 (62.8 %) procedures. Notably, one stroke event was recorded two months following DCCV.</div></div><div><h3>Conclusion</h3><div>A high rate of left atrial appendage thrombus was observed in ATTR-CM, leading to DCCV cancellation in 20.5% of patients. Despite a high immediate success rate (92.3%), sustained sinus rhythm control was achieved in only 62.8% following DCCV. These findings advise using TEE or CT prior to DCCV to exclude LAAT in ATTR-CM patients, even in those with oral anticoagulation.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101790"},"PeriodicalIF":2.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267289","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}