IJC Heart and Vasculature最新文献_第7页

The long-term prognostic value of CT coronary artery calcium score in asymptomatic patients with type 2 diabetes CT冠状动脉钙化评分对无症状2型糖尿病患者的长期预后价值

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-12-01 Epub Date: 2025-09-12 DOI: 10.1016/j.ijcha.2025.101799

Amir Aker , David Halon , Yuval Avidan , Amir Yahav , Shada Makhoul , Barak Zafrir

Background

Coronary artery calcium scoring (CACS) may improve risk stratification of diabetics, in whom coronary artery disease (CAD) is often more diffuse and progressive. We examined the long-term value of CACS in outcome prediction of asymptomatic patients with type 2 diabetes.

Methods

A population-based cohort recruited between 2006 and 2008 of type 2 diabetics aged 55–74 years, with at least one additional risk factor and no history or symptoms of CAD. The association of overall (n = 735) and individual vessel (n = 596) CACS with the occurrence of myocardial infarction (MI), ischemic stroke, or all-cause death (MACE) was assessed over a median follow-up of 17.3 years.

Results

Increasing levels of CACS independently predicted MACE and its components, particularly MI, with no events of MI observed in those with zero CACS, and an adjusted hazard ratio (95 % confidence interval) of 2.31 (1.30–4.11) for MI in those with CACS > 300 compared to 1–100 Agatston units. The addition of CACS to MESA 10-year coronary heart disease risk score increased significantly the discriminatory capacity for MI [combined AUC 0.75 (0.72–0.78)]. For each additional coronary artery with any CACS, the adjusted HR for MI was 1.68 (1.34–2.10), and for MACE 1.18 (1.08–1.30), p < 0.001. The hazard for MI or MACE did not increase in proportion to the percentage of CACS localized to the left-main coronary artery.

Conclusions

The predictive value of CACS in asymptomatic diabetics is retained over 17 years of follow-up, particularly for MI. The number of coronary arteries with calcified plaques may provide additional prognostic information.

背景冠状动脉钙化评分（CACS）可以改善糖尿病患者的风险分层，因为糖尿病患者的冠状动脉疾病（CAD）往往更弥漫性和进行性。我们研究了CACS在无症状2型糖尿病患者预后预测中的长期价值。方法以人群为基础的队列，招募年龄在55-74岁之间的2型糖尿病患者，至少有一个额外的危险因素，无CAD病史或症状。总体（n = 735）和单个血管（n = 596） CACS与心肌梗死（MI）、缺血性卒中或全因死亡（MACE）发生的相关性在17.3年的中位随访期间进行了评估。结果CACS水平的升高独立预测了MACE及其组成部分，特别是心肌梗死，在没有CACS的患者中没有观察到心肌梗死事件，与1-100 Agatston单位相比，CACS为300的患者心肌梗死的调整风险比（95%置信区间）为2.31（1.30-4.11）。MESA 10年冠心病风险评分中加入CACS可显著提高心肌梗死的鉴别能力[综合AUC为0.75(0.72-0.78)]。每增加一条冠状动脉，心肌梗死校正HR为1.68 (1.34-2.10)，MACE校正HR为1.18 (1.08-1.30),p < 0.001。心肌梗死或MACE的风险不随CACS局限于左主干冠状动脉的比例而增加。结论CACS对无症状糖尿病患者的预测价值在17年的随访中保持不变，特别是对心肌梗死患者。冠状动脉钙化斑块的数量可能提供额外的预后信息。

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引用次数: 0

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 改良体重指数作为非体外循环冠状动脉旁路移植术后住院死亡率的新预后指标：一项全国多中心队列研究

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-12-01 Epub Date: 2025-10-15 DOI: 10.1016/j.ijcha.2025.101823

Shipan Wang , Yilin Li , Hao Han , Tianxu Han , Zhiran Yang , Youjin Li , Haiping Yang , Hongli Li , Gang Liu , Minjia Zhu , Jian Huang , Qingwu Zhao , Jihong Liu , Haibin Li , Shuaitong Zhang , Yuan Xue , Hongjia Zhang , Haiyang Li

Background

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).

Methods

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.

Results

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 < 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 > 3 (P for association = 0.023, 0.013, and 0.049, respectively).

Conclusion

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.

Trial registration: Chinese Clinical Trial Registry: Chictr2400085741.

背景：营养不良是冠状动脉旁路移植术（CABG）患者普遍存在但尚未得到充分认识的合并症。修正BMI (mBMI)，定义为白蛋白× BMI，被认为是更准确的营养风险指标。本研究探讨了术前mBMI与非体外循环冠状动脉搭桥（OPCABG）后住院预后之间的关系。方法本回顾性队列研究纳入了在8个心脏中心行孤立性冠状动脉冠脉搭桥术的冠心病患者。根据术前mBMI值将患者分层。主要终点是住院死亡率。使用Logistic回归和受限三次样条模型来评估mBMI与预后之间的关系。根据临床特征进行亚组分析，包括性别、年龄、肾功能和合并症负担。结果在6667例患者中，最低mBMI组的住院死亡率（2.52% vs 1.53% vs 1.17%）、脑梗死（2.48% vs 2.34% vs 1.39%）和透析率（1.04% vs 0.54% vs 0.36%）均高于较高mBMI组（P均为0.05）。限制性三次样条分析显示mBMI与住院死亡率之间呈负相关，在mBMI 1300-1350附近观察到最低风险。亚组分析显示，这种关系在女性、eGFR≤90的患者和ASA评分为>； 3的患者中尤为显著（相关性P分别为0.023、0.013和0.049）。结论：较低的mBMI与OPCABG患者住院死亡率和多种不良结局的风险增加有关，特别是在女性和肾脏损害或全身性合并症患者中。试验注册：中国临床试验注册中心：Chictr2400085741。

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引用次数: 0

Increased dose of adenosine and the relationship between the resting full-cycle ratio and fractional flow reserve 腺苷剂量增加及静息全周期比与血流储备的关系

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-12-01 Epub Date: 2025-09-19 DOI: 10.1016/j.ijcha.2025.101803

Christian A. Christensen , Jens Trøan , Kirstine N. Hansen , Manijeh Noori , Anders Junker , Karsten Veien , Martin K. Christensen , Julia Ellert-Gregersen , Kristian Wachtell , Henrik S. Hansen , Jens F. Lassen , Diyako Qanie , Mikkel Hougaard , Lisette O. Jensen

Background

Intermediate coronary artery stenosis can be evaluated with fractional flow reserve (FFR) and resting full-cycle ratio (RFR) to determine if the stenosis is functionally significant. However, RFR and FFR have shown discordance in around 20% of examinations. One explanation could be that maximal hyperemia was not achieved during adenosine infusion. The aim was to investigate if increased doses of adenosine would reduce FFR further, and if the agreement between RFR and FFR would improve.

Method

Two hundred patients underwent physiological assessment of an intermediate stenosis with RFR and FFR at 140 µg/kg/min (FFR₁₄₀) and 200 µg/kg/min (FFR₂₀₀) of adenosine infusion. The microcirculation function was assessed using the index of microvascular resistance (IMR).

Results

Median RFR was 0.89 (interquartile range [IQR] 0.85–0.93). Median FFR decreased significantly during increased adenosine doses: FFR₁₄₀ = 0.85 (IQR 0.77–0.90) versus FFR₂₀₀ = 0.82 (IQR 0.75–0.87), p < 0.001. Reduction in FFR during increased adenosine doses was higher in patients with IMR ≥ 24 (FFR₁₄₀ 0.85 [IQR 0.78–0.92] versus FFR₂₀₀ 0.82 [IQR 0.75–0.86], p < 0.001) compared to patients with IMR < 24 (FFR₁₄₀ 0.83 [IQR 0.77–0.89] versus FFR₂₀₀ 0.81 [IQR 0.75–0.87], p < 0.001) with an absolute difference of −0.03 (−0.05, −0.01) versus −0.01 (−0.02, 0.0), p < 0.001. Area under the curve (AUC) of RFR compared to FFR₁₄₀ was 0.88 (95 % confidence interval [CI] 0.84–0.93), and for FFR_200, AUC was 0.88 (CI: 0.84–0.93).

Conclusion

Increased doses of adenosine significantly reduced FFR values, whereas the correlation agreement between RFR and FFR was not improved.

背景：中度冠状动脉狭窄可以通过血流储备分数（FFR）和静息全周期比（RFR）来评估，以确定狭窄是否具有功能显著性。然而，RFR和FFR在约20%的检查中显示不一致。一种解释可能是在腺苷输注期间没有达到最大充血。目的是研究增加剂量的腺苷是否会进一步降低FFR，以及RFR和FFR之间的一致性是否会改善。方法200例中度狭窄患者分别以140µg/kg/min （FFR140）和200µg/kg/min （FFR200）腺苷输注RFR和FFR进行生理评估。采用微血管阻力指数（IMR）评价微循环功能。结果中位RFR为0.89（四分位间距[IQR] 0.85 ~ 0.93）。中位FFR在腺苷剂量增加时显著降低：FFR140 = 0.85 (IQR 0.77-0.90) vs FFR200 = 0.82 (IQR 0.75-0.87), p < 0.001。与IMR≥24的患者（FFR140 0.85 [IQR 0.78-0.92] vs FFR200 0.82 [IQR 0.75-0.86], p < 0.001）相比，增加腺苷剂量时，IMR≥24的患者（FFR140 0.83 [IQR 0.77-0.89] vs FFR200 0.81 [IQR 0.75-0.87], p < 0.001）的FFR降低幅度更高，绝对差异为- 0.03 (- 0.05,- 0.01)vs - 0.01 (- 0.02, 0.0), p < 0.001。与FFR140相比，RFR的曲线下面积（AUC）为0.88(95%可信区间[CI] 0.84-0.93)， FFR200的AUC为0.88 （CI: 0.84-0.93）。结论增加腺苷剂量可显著降低FFR值，但RFR与FFR的相关性没有提高。

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引用次数: 0

Recent highlights from the International Journal of Cardiology Heart & Vasculature: Stroke prevention and rhythm control in patients with atrial fibrillation 国际心脏病学杂志心脏与脉管系统的最新亮点：房颤患者的卒中预防和节律控制

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-12-01 Epub Date: 2025-10-11 DOI: 10.1016/j.ijcha.2025.101816

Dominik Linz , Dobromir Dobrev

引用次数: 0

Macrophage Phospholipase D3 promotes atherosclerosis via exacerbating foam cell formation and inducing inflammatory responses 巨噬细胞磷脂酶D3通过加剧泡沫细胞形成和诱导炎症反应来促进动脉粥样硬化

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-12-01 Epub Date: 2025-10-31 DOI: 10.1016/j.ijcha.2025.101834

Teng Li , Xiaobao Gu , Xiangyang Yin , Pengbo Zhai , Hongxu Yan , Zixun Wang , Yang Li , Bing Wang

Background

Atherosclerosis is a chronic inflammatory disease and a major cause of global morbidity and mortality. Phospholipase D3 (PLD3) has been reported to be elevated in atherosclerotic plaques, yet its functional role and molecular mechanisms remain unclear. This study investigated the role of PLD3 in atherosclerosis.

Methods

Single-cell RNA sequencing of human atherosclerotic tissues was analyzed to define PLD3 expression. Validation was performed in ApoE^-/- mice and THP-1-derived foam cells by qRT-PCR and western blotting. Lentiviral-mediated PLD3 knockdown was followed by oxidized LDL (ox-LDL) stimulation. Lipid accumulation and uptake were assessed by Oil Red O, BODIPY, and DiI-ox-LDL assays, while inflammatory cytokines were quantified by qRT-PCR. RNA sequencing was conducted to explore downstream mechanisms.

Results

PLD3 expression was markedly upregulated in atherosclerotic lesions and enriched in plaque macrophages, with diagnostic value confirmed by ROC analysis. In vitro, ox-LDL induced PLD3 upregulation in THP-1 macrophages. PLD3 silencing reduced lipid accumulation and uptake through downregulation of CD36, while concurrently decreasing IL-1β and TNF-α expression. Mechanistically, PLD3 deficiency suppressed NF-κB pathway activation.

Conclusion

PLD3 is highly expressed in plaque macrophages and promotes atherosclerosis by enhancing CD36-mediated lipid accumulation and activating NF-κB–driven inflammation. These findings identify PLD3 as a potential therapeutic target for atherosclerotic disease.

动脉粥样硬化是一种慢性炎症性疾病，是全球发病率和死亡率的主要原因。磷脂酶D3 （PLD3）在动脉粥样硬化斑块中升高，但其功能作用和分子机制尚不清楚。本研究探讨PLD3在动脉粥样硬化中的作用。方法分析人动脉粥样硬化组织的单细胞RNA测序，确定PLD3的表达。通过qRT-PCR和western blotting在ApoE^-/-小鼠和thp -1衍生泡沫细胞中进行验证。慢病毒介导的PLD3敲低之后是氧化LDL （ox-LDL）刺激。脂质积累和摄取通过Oil Red O、BODIPY和DiI-ox-LDL检测来评估，炎症细胞因子通过qRT-PCR来量化。通过RNA测序来探索其下游机制。结果spld3在动脉粥样硬化病变中表达明显上调，在斑块巨噬细胞中表达丰富，经ROC分析证实具有诊断价值。在体外，ox-LDL诱导THP-1巨噬细胞PLD3上调。PLD3沉默通过下调CD36减少脂质积累和摄取，同时降低IL-1β和TNF-α的表达。在机制上，PLD3缺乏抑制NF-κB通路的激活。结论pld3在斑块巨噬细胞中高表达，通过增强cd36介导的脂质积累和激活NF-κ b驱动的炎症来促进动脉粥样硬化。这些发现确定PLD3是动脉粥样硬化疾病的潜在治疗靶点。

{"title":"Macrophage Phospholipase D3 promotes atherosclerosis via exacerbating foam cell formation and inducing inflammatory responses","authors":"Teng Li , Xiaobao Gu , Xiangyang Yin , Pengbo Zhai , Hongxu Yan , Zixun Wang , Yang Li , Bing Wang","doi":"10.1016/j.ijcha.2025.101834","DOIUrl":"10.1016/j.ijcha.2025.101834","url":null,"abstract":"<div><h3>Background</h3><div>Atherosclerosis is a chronic inflammatory disease and a major cause of global morbidity and mortality. Phospholipase D3 (PLD3) has been reported to be elevated in atherosclerotic plaques, yet its functional role and molecular mechanisms remain unclear. This study investigated the role of PLD3 in atherosclerosis.</div></div><div><h3>Methods</h3><div>Single-cell RNA sequencing of human atherosclerotic tissues was analyzed to define PLD3 expression. Validation was performed in ApoE^-/- mice and THP-1-derived foam cells by qRT-PCR and western blotting. Lentiviral-mediated PLD3 knockdown was followed by oxidized LDL (ox-LDL) stimulation. Lipid accumulation and uptake were assessed by Oil Red O, BODIPY, and DiI-ox-LDL assays, while inflammatory cytokines were quantified by qRT-PCR. RNA sequencing was conducted to explore downstream mechanisms.</div></div><div><h3>Results</h3><div>PLD3 expression was markedly upregulated in atherosclerotic lesions and enriched in plaque macrophages, with diagnostic value confirmed by ROC analysis. In vitro, ox-LDL induced PLD3 upregulation in THP-1 macrophages. PLD3 silencing reduced lipid accumulation and uptake through downregulation of CD36, while concurrently decreasing IL-1β and TNF-α expression. Mechanistically, PLD3 deficiency suppressed NF-κB pathway activation.</div></div><div><h3>Conclusion</h3><div>PLD3 is highly expressed in plaque macrophages and promotes atherosclerosis by enhancing CD36-mediated lipid accumulation and activating NF-κB–driven inflammation. These findings identify PLD3 as a potential therapeutic target for atherosclerotic disease.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101834"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416939","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

Thromboembolic risk of electrical cardioversion in patients with cardiogenic shock 心源性休克患者电转复的血栓栓塞风险

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-12-01 Epub Date: 2025-11-06 DOI: 10.1016/j.ijcha.2025.101835

Jonas Gmeiner , Lea Haag , Enzo Lüsebrink , Jan-Philipp Simon , Felix Michelson , Elina Oesterhaus , Wolf-Stephan Rudi , Ludwig Weckbach , Stefan Kääb , Michael Näbauer , Sven Peterß , Christopher Stremmel , Steffen Massberg , Martin Orban , Moritz F. Sinner , Clemens Scherer

Background

Cardiogenic shock patients with atrial fibrillation or flutter often require acute cardioversion despite absence of sufficient anticoagulation or the possibility to rule out left atrial appendage thrombus. Thromboembolic risk in these patients is unknown.

Methods

In this study, all cardiogenic shock patients from the LMUshock registry undergoing electrical cardioversion for atrial fibrillation or atrial flutter were included. The primary endpoint was new thromboembolic stroke or systemic embolism at 30 days. Secondary endpoints included performance of transesophageal echocardiography, all-cause mortality and bleeding according to BARC.

Results

Of 140 patients undergoing electrical cardioversion, 36 had preexisting and 104 experienced new onset of atrial fibrillation or flutter during ICU stay. Of these, 87.1 % had anticoagulation with unfractionated heparin and anticoagulation was adjudicated sufficient in 44.3 % at the time of cardioversion. Transesophageal echocardiography was performed in 37.9 % of patients before cardioversion. The primary endpoint was met in 3 patients (2.1 %), all of which had insufficient anticoagulation. All-cause mortality at 30 days was 37.9 % and bleeding ≥ BARC type 3a was found in 12.9 %.

Conclusions

Thromboembolic risk of electrical cardioversion was low despite the limited utilization of transesophageal echocardiography. This may be attributed to the routine administration of therapeutic anticoagulation in this study, but a high incidence of bleeding was observed.

背景：心源性休克合并心房颤动或扑动的患者，尽管没有足够的抗凝治疗或排除左心房附件血栓的可能性，但往往需要急性心律转复。这些患者的血栓栓塞风险尚不清楚。方法本研究纳入lmusshock登记的所有因心房颤动或心房扑动而接受电复律治疗的心源性休克患者。主要终点是30天内新的血栓栓塞性卒中或全身性栓塞。次要终点包括经食管超声心动图表现、全因死亡率和根据BARC的出血。结果140例电复律患者中，36例已存在心房颤动或扑动，104例在ICU住院期间新发。其中，87.1%的患者使用了未分级肝素抗凝治疗，44.3%的患者在复律时认为抗凝治疗是充分的。37.9%的患者在复律前进行了经食管超声心动图检查。3例（2.1%）患者达到了主要终点，所有患者抗凝治疗不足。30天全因死亡率为37.9%，出血≥BARC 3a型占12.9%。结论尽管经食管超声心动图的应用有限，但电转复的血栓栓塞风险较低。这可能是由于在本研究中常规给予治疗性抗凝，但观察到出血的发生率很高。

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引用次数: 0

Coronary artery calcium on lung cancer screening-CT: An opportunity to optimize cardiovascular disease risk reduction 肺癌ct筛查冠状动脉钙化：优化心血管疾病风险降低的机会

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-12-01 Epub Date: 2025-10-21 DOI: 10.1016/j.ijcha.2025.101826

Bethlehem Mengesha , Keren Mbondo Kasuku , Toby David Small , Marcella Cabral Caires , Habibat Garuba , Angeline Law , Christopher Johnson , David Ian Paterson , Carole Dennie , Elena Pena , Benjamin JW Chow , Gary R Small

Background

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.

Methods

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.

Results

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 < 0.001). On multivariable analysis, increased Framingham risk score (OR 2.31 95 % CI 1.73–2.31, p < 0.001) and reported coronary artery calcium (OR 1.53 95 % CI 1.22–1.92, p < 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.

Conclusions

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.

在肺癌筛查试验中，心血管疾病的死亡率与肺癌的死亡率相似。如果有针对性地预防动脉粥样硬化，可以优化肺癌筛查后的生存率。因此，我们试图确定基于冠状动脉钙和心血管风险评估的心血管风险降低治疗率是否有改善的潜力。方法从安大略省高危肺癌筛查试点项目中首次连续1486例无冠状动脉疾病的患者的电子病历中检索临床肺癌筛查- ct报告、降脂治疗和临床人口统计学资料。本文回顾了肺癌筛查CT图像对冠状动脉钙的存在和范围。结果冠状动脉钙化检出率83%，报告率63%。60%报告了冠状动脉钙化的患者开了降脂处方，而未报告冠状动脉钙化的患者只有45%开了降脂处方（p < 0.001）。在多变量分析中，Framingham风险评分（OR 2.31 95% CI 1.73-2.31, p < 0.001）和冠状动脉钙化（OR 1.53 95% CI 1.22-1.92, p < 0.001）升高与降脂治疗相关。21%的患者使用冠状动脉钙化可以进一步降低心血管风险，44%的患者在进一步考虑临床风险的情况下可以进一步降低心血管风险。结论在肺癌筛查患者中，通过冠状动脉钙的合理使用和临床评估，可以明显优化心血管风险的降低。适当降低心血管风险可以降低这些个体中心血管死亡的高流行率，并提高总体生存率。

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引用次数: 0

Relationship between baseline right ventricular systolic function and left ventricular recovery at six-months of follow up among women with peripartum cardiomyopathy in Uganda 乌干达围产期心肌病妇女随访6个月时基线右心室收缩功能与左心室恢复的关系

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-12-01 Epub Date: 2025-09-07 DOI: 10.1016/j.ijcha.2025.101788

Juliet Nabbaale , Emmy Okello , Annettee Nakimuli , Graham Chakafana , Karen Sliwa

Background

LV recovery in Peripartum Cardiomyopathy (PPCM) depends on several baseline factors including left ventricular ejection fraction (LVEF), LV end-diastolic diameter (LVEDD), duration of symptoms. The role baseline RV function in LV recovery remains poorly described. This study sought to determine the relationship between baseline RV systolic function and LV recovery at six-months follow up among women with PPCM in Uganda.

Methods

Prospective cohort study of 80 PPCM cases and 80 healthy matched controls observed over a 6-month period while on goal-directed medical therapy (GDMT). All enrolled participants had a 12-lead electrocardiography, echocardiography at baseline and at 6-months follow-up for assessment of LV systolic function using LV global longitudinal strain (LV GLS) and LV EF whereas RV systolic function was assessed using; fractional area change (FAC), tricuspid annular plane excursion (TAPSE), RV lateral wall S’ (RV S’), fractional wall strain (FWS) and RV global longitudinal strain (RV GLS).

Results

The mean data of cases included age of 33.6 ± 6.6 years, LVEF 35.7 ± 11.0 %, LV GLS −11.9 ± 4.7 % and RV GLS −14.7 ± 10.9 %, RV FAC 32.9 ± 13.5 %, Lat S’ 10.6 ± 3.0 cm/s and RV FWS −17.1 ± 7.2 %. LV recovery occurred among 46.3 % cases. Factors which predicted LV recovery included heart rate and LVEDD.

Conclusion

Under half of PPCM cases had LV recovery at six-months on GDMT and Bromocriptine. Baseline heart rate and LVEDD predicted LV recovery.

背景围产期心肌病（PPCM）的左室恢复取决于几个基线因素，包括左室射血分数（LVEF）、左室舒张末期内径（LVEDD）、症状持续时间。基线RV功能在左室恢复中的作用仍然描述不清。本研究旨在确定基线左室收缩功能与6个月随访时乌干达PPCM妇女左室恢复之间的关系。方法对80例PPCM病例和80例健康对照进行前瞻性队列研究，观察了6个月的目标导向药物治疗（GDMT）。所有入组的参与者在基线和随访6个月时进行12导联心电图、超声心动图检查，使用左室总纵应变（LV GLS）和左室EF评估左室收缩功能，而左室收缩功能评估使用；分数面积变化（FAC）、三尖瓣环形平面偏移（TAPSE）、RV侧壁S′（RV S′）、分数壁应变（FWS）和RV整体纵向应变（RV GLS）。结果患者平均年龄为33.6±6.6岁，LVEF为35.7±11.0%，lgls为- 11.9±4.7%，lgls为- 14.7±10.9%，lfac为32.9±13.5%，Lat S为10.6±3.0 cm/ S， rvfws为- 17.1±7.2%。46.3%的患者出现左室恢复。预测左室恢复的因素包括心率和LVEDD。结论经GDMT和溴隐亭治疗6个月后，不到一半的PPCM患者左室恢复。基线心率和LVEDD预测左室恢复。

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引用次数: 0

Decoding the coronary paradox of obesity: not all fat is equal! 解读肥胖的冠状动脉悖论：并非所有脂肪都是一样的！

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-12-01 Epub Date: 2025-09-27 DOI: 10.1016/j.ijcha.2025.101807

Gaetano Santulli , Shivangi Pande , Pasquale Mone , Fahimeh Varzideh

引用次数: 0

Role of ruxolitinib in preventing cardiac arrhythmias: A pooled analysis of clinical studies in hematology 鲁索利替尼在预防心律失常中的作用：血液学临床研究的汇总分析

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-12-01 Epub Date: 2025-09-26 DOI: 10.1016/j.ijcha.2025.101810

Silvia Zaoli , Manish Khatri , Bjoern Holzhauer , Severine Peyrard , AnaRita Ferreira , Tommaso Stefanelli

引用次数: 0