IJC Heart and Vasculature最新文献_第9页

Accelerated biological aging and incident degenerative valvular heart disease: Findings from 408,783 UK Biobank participants 加速生物老化和退行性瓣膜病的发生：来自408,783名英国生物银行参与者的研究结果

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-12-01 Epub Date: 2025-11-14 DOI: 10.1016/j.ijcha.2025.101838

Chaoyang Lin , Enhao Wei , Qianyao Lai , Hangpan Jiang , Maosen Lin , Feng Hu , Lin Fan , Enhui Yao

Background

Although prior studies have linked frailty and accelerated biological aging to aortic stenosis, comprehensive evidence across the spectrum of degenerative valvular diseases (VHD) and related clinical events remains unclear in middle-aged adults.

Methods

We analyzed 408,783 UK Biobank participants free of baseline valvular disease. Biological age accelerations (BAA) measures were derived from clinical traits using Phenotypic Age (PhenoAge) algorithm and the Klemera-Doubal method Biological Age (KDM-BA). Outcomes included incident aortic stenosis (AS), aortic regurgitation (AR), mitral regurgitation (MR), and related interventions or mortality.

Results

Over a median follow-up of 13.9 years, 10,364 incident degenerative VHD events (2.5 %) were documented, comprising 4602 AS, 1678 AS-related events, 1639 AR, and 4903 MR cases. Elevated BAA was significantly associated with higher AS risk. For PhenoAge, adjusted AS incidence rates (per 10,000 person-years; 95 % confidence interval) across quartiles (Q1–Q4) were 3.73 (3.37–4.12), 4.44 (4.05–4.88), 5.11 (4.67–5.59), and 7.79 (7.18–8.46), yielding an adjusted hazard ratio (HR) of 2.15 (1.96–2.35) for Q4. Comparable trends were observed for KDM-BA, with an adjusted HR of 1.98 (1.83–2.15) for Q4 vs Q1. AS-related events followed a similar pattern, with HRs of 1.80 (1.55–2.09) for PhenoAge Q4 and 2.22 (1.94–2.54) for KDM-BA Q4. Significant associations were also found for AR, AR-related events, and MR, but not for MR-related events.

Conclusions

Among middle-aged adults, both BAA metrics were associated with increased risks of degenerative VHD and related adverse events, except for MR-related events. These findings highlight BAA as a potential tool for early risk stratification and targeted prevention.

尽管先前的研究已经将身体虚弱和加速的生物衰老与主动脉瓣狭窄联系起来，但中年人退行性瓣膜疾病（VHD）和相关临床事件的全面证据仍不清楚。方法我们分析了408,783名无基线瓣膜疾病的英国生物银行参与者。采用表型年龄（phenotype age）算法和klemera - double方法生物年龄（KDM-BA）从临床特征中得出生物年龄加速（BAA）指标。结果包括主动脉瓣狭窄（AS）、主动脉瓣反流（AR）、二尖瓣反流（MR）以及相关干预措施或死亡率。结果在13.9年的中位随访中，记录了10,364例退行性VHD事件（2.5%），包括4602例AS， 1678例AS相关事件，1639例AR和4903例MR。BAA升高与AS风险升高显著相关。对于PhenoAge，四分位数（Q1-Q4）的调整后AS发病率（每10,000人年；95%可信区间）分别为3.73（3.37-4.12）、4.44（4.05-4.88）、5.11（4.67-5.59）和7.79(7.18-8.46)，第四季度的调整后风险比（HR）为2.15（1.96-2.35）。KDM-BA也有类似的趋势，第四季度与第一季度的调整后风险比为1.98（1.83-2.15）。与as相关的事件遵循类似的模式，表型Q4的hr为1.80 (1.55-2.09)，KDM-BA Q4的hr为2.22（1.94-2.54）。AR、AR相关事件和MR也有显著相关性，但MR相关事件没有显著相关性。结论：在中年人中，BAA指标与退行性VHD和相关不良事件的风险增加相关，mr相关事件除外。这些发现强调了BAA作为早期风险分层和有针对性预防的潜在工具。

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引用次数: 0

Sex differences in cardiac sarcoidosis 心脏结节病的性别差异

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-12-01 Epub Date: 2025-08-30 DOI: 10.1016/j.ijcha.2025.101777

Katrina A. Williamson , Jenna M. Davison , Andrew N. Rosenbaum , Panithaya Chareonthaitawee , Nikhil Kolluri , John P. Bois , Omar F Abou Ezzeddine , John A. Schirger , Suraj Kapa , Konstantinos C. Siontis , Leslie T. Cooper , Courtney A. Arment

Background

Cardiac sarcoidosis (CS) is an inflammatory cardiomyopathy for which sex differences outcomes are not well described.

Objectives

This study aimed to understand differences in CS presentation, complications, and outcomes between females and males.

Methods

Patients meeting Japanese Circulation Society or Heart Rhythm Society criteria for CS were evaluated at a single institution from January 1, 1999, to December 31, 2023 (n = 455). Presenting characteristics including demographics, symptoms, conduction abnormalities, arrhythmias and left ventricular ejection fraction (LVEF) between females and males were compared. Sex-based differences in hospitalizations, LVAD implantation, transplantation and death were analyzed.

Results

The cohort was mostly male (60.7 %). Females presented at an older age (58.5, IQR 51–65 in females, vs 54, IQR 45–61 in males, p = 0.001), and more females experienced palpitations (46.4 %, p = 0.04), chest pain (34.6 % p = 0.02), and fatigue (53.6 % p = 0.01) at presentation. Females had higher New York Heart Association (NYHA) class (III or IV) (31.5 % vs 21.8 %; p = 0.05), and higher NT-proBNP (467 in females vs 257.5 in males, p = 0.03) at presentation. Cardiovascular hospitalization–free survival, LVAD/transplant-free survival, and overall survival were not significantly different.

Conclusions

Females presented at an older age and were more symptomatic with higher NYHA class symptoms than males, suggesting that females are presenting or being diagnosed with CS later than males. LVEF, rates of heart block, and ventricular arrhythmias were similar between sexes, suggesting greater heart failure severity in females with CS may be related to greater left ventricular stiffening or worse valvular disease. Differences in survival outcomes were not significant.

背景：心脏结节病（CS）是一种炎症性心肌病，其性别差异的结局尚未得到很好的描述。目的本研究旨在了解女性和男性CS表现、并发症和结局的差异。方法1999年1月1日至2023年12月31日，在同一家机构对符合日本循环学会或心律学会CS标准的患者进行评估（n = 455）。比较男女患者的人口学特征、症状、传导异常、心律失常和左心室射血分数（LVEF）。分析了住院、LVAD植入、移植和死亡的性别差异。结果本组以男性为主（60.7%）。女性发病年龄较大（女性为58.5，IQR为51-65，男性为54，IQR为45-61，p = 0.001），更多女性发病时出现心悸（46.4%,p = 0.04）、胸痛（34.6% p = 0.02）和疲劳（53.6% p = 0.01）。女性就诊时纽约心脏协会（NYHA） III级或IV级较高（31.5% vs 21.8%, p = 0.05）， NT-proBNP较高（女性467 vs男性257.5,p = 0.03）。无心血管住院生存、无LVAD/无移植生存和总生存无显著差异。结论与男性相比，女性出现的年龄更大，NYHA级症状更高，提示女性出现或诊断CS的时间晚于男性。LVEF、心脏传导阻滞率和室性心律失常在两性之间相似，提示CS女性患者心衰严重程度越大，可能与左心室僵硬或瓣膜疾病更严重有关。生存结果的差异不显著。

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引用次数: 0

Linking factor XIII activity to all-cause mortality after myocardial infarction: the overlooked role of serum albumin 将因子XIII活性与心肌梗死后的全因死亡率联系起来：血清白蛋白被忽视的作用

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-12-01 Epub Date: 2025-09-11 DOI: 10.1016/j.ijcha.2025.101796

Jan Traub , Makram Abu Hussein , Dominik Schmitt , Anna Frey

Background

Acute myocardial infarction (MI) remains a major cause of morbidity and mortality despite therapeutic advances. Factor XIII (FXIII), a fibrin-stabilizing enzyme with roles in coagulation, inflammation, and tissue repair, has emerged as a potential biomarker in MI. While low FXIII activity has been linked to adverse outcomes, the underlying determinants and its independent prognostic value remain unclear.

Methods

In this retrospective study, FXIII activity was measured in 926 MI patients treated at University Hospital Würzburg between 2018 and 2023. Blood samples were collected within 24 h of cardiac catheterization. FXIII activity was assessed photometrically, and patients were followed for all-cause mortality. Multivariable regression and Cox models were used to identify predictors of FXIII activity and mortality.

Results

Median FXIII activity was 110 %. Lower FXIII activity was associated with older age, female sex, lower albumin, higher CRP, and reduced kidney function. While crude mortality at 30 days and 1 year was significantly higher in patients with FXIII ≤ 110 %, FXIII activity was not an independent predictor of mortality after adjustment. Key predictors included albumin (HR = 0.221, p < 0.001), age (HR = 1.048, p < 0.001), eGFR (HR = 0.988, p = 0.001), and ASAT (HR = 1.001, p = 0.002).

Conclusions

Although lower FXIII activity is associated with higher mortality post-MI, this effect is largely mediated by albumin levels. Albumin appears to be a central determinant of both FXIII activity and prognosis, highlighting its potential role as a key marker in risk stratification. Further studies are warranted to explore therapeutic implications of hypoalbuminemia in MI.

背景：尽管治疗进展，急性心肌梗死（MI）仍然是发病率和死亡率的主要原因。因子XIII （FXIII）是一种纤维蛋白稳定酶，在凝血、炎症和组织修复中发挥作用，已成为心肌梗死的潜在生物标志物。虽然低FXIII活性与不良结局有关，但其潜在的决定因素及其独立的预后价值尚不清楚。方法在这项回顾性研究中，测量了2018年至2023年在德国 rzburg大学医院治疗的926例心肌梗死患者的FXIII活性。心导管置管后24小时内采集血样。用光度法评估FXIII活性，并随访患者的全因死亡率。采用多变量回归和Cox模型确定FXIII活性和死亡率的预测因子。结果FXIII活性中位数为110%。较低的FXIII活性与年龄较大、女性、较低的白蛋白、较高的CRP和肾功能降低有关。虽然FXIII≤110%的患者30天和1年的粗死亡率明显更高，但调整后FXIII活性并不是死亡率的独立预测因子。主要预测因子包括白蛋白(HR = 0.221, p & lt; 0.001)、年龄(HR = 1.048, p & lt; 0.001)、表皮生长因子受体(HR = 0.988, p = 0.001),和ASAT (HR = 1.001, p = 0.002)。结论：虽然FXIII活性降低与心肌梗死后死亡率升高有关，但这种影响主要是由白蛋白水平介导的。白蛋白似乎是FXIII活性和预后的中心决定因素，突出了其作为风险分层关键标志物的潜在作用。有必要进一步研究低白蛋白血症对心肌梗死的治疗意义。

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引用次数: 0

Clinical utility of segmental native T1 mapping for diagnosis and risk-stratification in cardiac sarcoidosis 局部T1定位在心脏结节病诊断和风险分层中的临床应用

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-12-01 Epub Date: 2025-08-29 DOI: 10.1016/j.ijcha.2025.101787

Hidehiro Iwakawa , Nobuhiro Suzuki , Hirokazu Yoshida , Yohei Sasaki , Ryosuke Kato , Ryota Kaimori , Hiroyuki Watanabe

Background

The clinical utility and optimal analytical approach for native T1 mapping in cardiac sarcoidosis (CS) remain unclear. This study investigated the clinical value of segmental native T1 assessment in patients with CS.

Methods

We recruited 55 participants, including 41 patients undergoing diagnostic evaluation of CS and 14 healthy controls. Of the 41 patients, 29 were diagnosed with CS and 12 were classified as non-CS. Segmental cardiac magnetic resonance findings of the left ventricle were evaluated using a 1.5-T scanner. The primary endpoint was a composite of all-cause death, fatal ventricular arrhythmia, bradycardia, or hospitalization for cardiovascular events.

Results

Maximum and global native T1 values were significantly higher in CS patients than in healthy controls and non-CS patients. Maximum and global T1 values demonstrated comparable predictive performance in differentiating CS from the other groups, with areas under the curve (AUCs) of 0.92 and 0.90, respectively. The AUC for predicting segments with late gadolinium enhancement (LGE) was highest for extracellular volume, followed by native T1 and T2 (P < 0.05 for all). Patients with six or more segments showing native T1 ≥ 1091 ms had a significantly worse prognosis than those without (55.6 % vs. 18.2 %, P = 0.028).

Conclusions

Maximum and global native T1 values were highly predictive for differentiating CS. The high segmental native T1 values in patients with CS may reflect the regional presence of LGE. Segmental native T1 assessment can aid in estimating long-term outcomes.

背景心脏结节病（CS）原生T1定位的临床应用和最佳分析方法尚不清楚。本研究探讨节段性原生T1评估在CS患者中的临床价值。方法我们招募了55名参与者，包括41名接受CS诊断评估的患者和14名健康对照。在41例患者中，29例诊断为CS， 12例归类为非CS。使用1.5 t扫描仪评估左心室节段性心脏磁共振结果。主要终点为全因死亡、致死性室性心律失常、心动过缓或因心血管事件住院。结果CS患者的最大T1值和总体T1值显著高于健康对照组和非CS患者。最大T1值和全局T1值在区分CS与其他组方面表现出可比的预测性能，曲线下面积（auc）分别为0.92和0.90。预测晚期钆增强（LGE）节段的AUC以细胞外体积最高，其次是原生T1和T2 （P < 0.05）。具有6个或更多原生T1≥1091 ms的患者预后明显差于无原生T1≥1091 ms的患者（55.6% vs. 18.2%, P = 0.028）。结论最大T1值和全局T1值对CS的鉴别具有较高的预测价值。CS患者的高节段原生T1值可能反映LGE的区域性存在。局部T1评估有助于评估长期预后。

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引用次数: 0

Role of miR-21-5p in the pathogenesis of abdominal aortic aneurysm regarding the Th17 pathway miR-21-5p在腹主动脉瘤Th17通路发病中的作用

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-12-01 Epub Date: 2025-10-09 DOI: 10.1016/j.ijcha.2025.101821

Dorota Studzińska , Sabina Lichołai , Kamil Polok , Hanna Plutecka , Piotr Kica , Piotr Grazda , Maciej Chwała , Marek Sanak , Wojciech Szczeklik

Background and aims

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.

Methods

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.

Results

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.

Conclusion

Our study showed that, regarding AAA pathogenesis, endothelial dysfunction followed by inflammation could be mediated by an increased level of miR-21-5p.

背景与目的在腹主动脉瘤（AAA）发病机制中，th17相关免疫活性与mirna驱动调控之间的相互作用尚不清楚。在这项前瞻性研究中，我们旨在评估Th17通路紊乱对应的miR-21-5p在AAA发展中的潜在作用。方法在住院当天收集真肾下AAA患者、择期腹主动脉开腹手术患者和未伴有动脉瘤的外周动脉疾病（PAD）患者的生物学样本。术中收集患者腹主动脉动脉瘤组织碎片。从样本中提取总RNA，分别使用实时荧光定量PCR （RT-qPCR）和Luminex检测方法评估miR-21-5p和Th17通路相关标记物的表达水平。此外，我们使用人内皮细胞进行了体外模型，转染了合成的miR-21-5p模拟物。结果纳入60例患者，其中研究组30例，对照组30例，采用倾向评分匹配法。与对照组相比，AAA患者的循环miR-21-5p水平显著升高。miR-21-5p下调参与内皮发育、血管通透性调节或内皮细胞对生长因子反应的基因。我们发现，AAA患者的Th17循环介质含量高于对照组，动脉瘤主动脉中部的Th17循环介质含量高于上极。结论我们的研究表明，在AAA的发病机制中，miR-21-5p水平升高可能介导内皮功能障碍随后的炎症。

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引用次数: 0

Cardamonin attenuates angiotensin II-induced abdominal aortic aneurysms through activation of the Nrf2/HO-1 pathway 小豆蔻素通过激活Nrf2/HO-1通路减轻血管紧张素ii诱导的腹主动脉瘤

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-12-01 Epub Date: 2025-10-06 DOI: 10.1016/j.ijcha.2025.101815

Hsiao-Ya Tsai , Yu-Juei Hsu , Chih-Yuan Lin , Po-Hsun Huang , Chin-Wang Hsu , Shih-Hung Tsai

Background

Cardamonin is a natural chalcone compound. It has been shown to have various pharmacological properties. Cardamonin can activate the Nrf2 signaling pathway. Abdominal aortic aneurysm (AAA) is a complex degenerative aortic disease. Ruptured AAAs continue to be among the leading causes of sudden death in elderly individuals. No medical therapy has proven clinical benefits for preventing AAA progression. Therefore, an adjunctive medical therapy is essential to address this unmet clinical need.

Methods

Human aortic smooth muscle cells (HASMCs) were used to determine the molecular mechanism of cardamonin. A murine model of angiotensin II (AngII)-induced AAA was used to assess the therapeutic effects of cardamonin on AAA growth in apolipoprotein E knockout (ApoE KO) mice in vivo. Immunoblotting, senescence assays, and reactive oxygen species (ROS) production assays were used to determine the protective effects of cardamonin in vivo and in vitro.

Results

Cardamonin induced Nrf2 translocation from the cytosol to the nuclear compartment in HASMCs. Cardamonin reduced AngII-induced ROS production and matrix metalloproteinases (MMPs) overexpression through activation of the Nrf2/heme oxygenase-1 (HO-1) antioxidant pathway in HASMCs. Silencing HO-1 attenuated the anti-ROS effects of cardamonin and abolished the protective effects of cardamonin in AngII-challenged HASMCs. Cardamonin (20 mg/kg/day) reduced AngII-induced AAA in vivo. Cardamonin also reduced the overexpression of MMPs and the production of ROS and attenuated elastin degradation in aortic tissues.

Conclusion

Cardamonin inhibits the progression of AngII-induced AAA through Nrf2/HO-1-mediated antioxidant and anti-inflammatory pathways. Cardamonin could have the potential to be an adjunctive therapy for small AAAs.

小豆蔻素是一种天然查尔酮化合物。它已被证明具有多种药理特性。小豆蔻素可以激活Nrf2信号通路。腹主动脉瘤（AAA）是一种复杂的退行性主动脉疾病。AAAs破裂仍然是老年人猝死的主要原因之一。没有任何药物治疗被证实对预防AAA进展有临床益处。因此，辅助医学治疗对于解决这一未满足的临床需求至关重要。方法采用人主动脉平滑肌细胞（HASMCs）研究小豆蔻素的分子机制。采用血管紧张素II （AngII）诱导的小鼠AAA模型，在体内评估小豆蔻素对载脂蛋白E敲除（ApoE KO）小鼠AAA生长的治疗作用。采用免疫印迹、衰老测定和活性氧（ROS）产生测定来确定小豆蔻素在体内和体外的保护作用。结果scardamonin诱导Nrf2从HASMCs细胞质转移到核室。小豆蔻素通过激活Nrf2/血红素氧化酶-1 （HO-1）抗氧化途径，降低血管内皮细胞诱导的ROS生成和基质金属蛋白酶（MMPs）的过度表达。沉默HO-1可减弱小豆蔻素的抗ros作用，并消除小豆蔻素在血管损伤的HASMCs中的保护作用。小豆蔻素（20 mg/kg/day）在体内降低血管损伤诱导的AAA。小豆蔻素还能降低主动脉组织中MMPs的过表达和ROS的产生，并减弱弹性蛋白的降解。结论小豆蔻素通过Nrf2/ ho -1介导的抗氧化和抗炎途径抑制血管内皮细胞诱导的AAA的进展。小豆蔻素有可能成为小型AAAs的辅助治疗方法。

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引用次数: 0

Integrated proteomics and metabolomics analyses reveal potential molecular signatures of rabbit atherosclerotic plaques 综合蛋白质组学和代谢组学分析揭示了兔动脉粥样硬化斑块的潜在分子特征

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-12-01 Epub Date: 2025-11-08 DOI: 10.1016/j.ijcha.2025.101840

Chunfang Zan , Tianxiong Ji , Xinyu Zhang , Min-Fu Yang , Zhifang Wu , Sijin Li

Objective

This study aims to explore potential mechanisms associated with differentially abundant proteins and metabolites in rabbit plaques through integrated proteomics and untargeted metabolomics analyses.

Methods

Experimental rabbits were randomly divided into the model group and the sham group. Abdominal aortas were isolated, collected, and treated with proteinase K. Subsequently, a tandem mass tag (TMT)-labeled quantitative proteomics analysis and an untargeted metabolomics analysis via liquid chromatography-mass spectrometry (LC-MS) of abdominal aortas were performed to evaluate the possible protein and metabolite fingerprints in arterial plaques. Acquired data were analyzed using uni‐ and multivariate statistics. The correlation between differentially abundant proteins and metabolites was analyzed using the Pearson correlation coefficient strategy, and their possibly involved functional pathways were predicted by Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis.

Results

Advanced plaques develop in the model group. A total of 207 proteins are significantly altered in injured aortas compared to uninjured ones, with 133 upregulated and 74 downregulated proteins (fold changes > 1.2, P < 0.05). In plaques, 234 metabolites are significantly changed under the positive ion mode, and 187 under the negative ion mode. Notably, increases are observed in phosphatidylcholines (PCs) [PC 9:0] and lysophosphatidylcholines (LPCs) [LPC 20:2], two key lipid components. These metabolites are involved in some key metabolic pathways, including purine metabolism and vascular smooth muscle contraction.

Conclusions

The results confirm the potential of integrated proteomics and untargeted metabolomics in exploring the molecular characteristics of atherosclerosis. Identified proteins and metabolites may serve as promising biomarkers for plaque diagnosis.

目的本研究旨在通过综合蛋白质组学和非靶向代谢组学分析，探索兔斑块中差异丰富的蛋白质和代谢物的潜在机制。方法将实验兔随机分为模型组和假手术组。分离、收集腹主动脉并用蛋白酶k处理，随后对腹主动脉进行串联质量标签（TMT）标记的定量蛋白质组学分析和液相色谱-质谱（LC-MS）的非靶向代谢组学分析，以评估动脉斑块中可能的蛋白质和代谢物指纹图谱。使用单变量和多变量统计分析获得的数据。利用Pearson相关系数分析差异丰富蛋白与代谢物之间的相关性，并利用京都基因基因组百科全书（KEGG）富集分析预测其可能参与的功能通路。结果模型组出现晚期斑块。损伤主动脉与未损伤主动脉相比，共有207个蛋白发生显著改变，其中133个蛋白上调，74个蛋白下调（fold changes > 1.2, P < 0.05）。在斑块中，234种代谢物在正离子模式下发生显著变化，187种在负离子模式下发生显著变化。值得注意的是，两种关键的脂质成分磷脂酰胆碱（PCs） [pc9:0]和溶血磷脂酰胆碱（LPCs） [LPC 20:2]的含量均有所增加。这些代谢物参与一些关键的代谢途径，包括嘌呤代谢和血管平滑肌收缩。结论综合蛋白质组学和非靶向代谢组学在探索动脉粥样硬化分子特征方面具有一定的潜力。鉴定的蛋白质和代谢物可能作为斑块诊断的有希望的生物标志物。

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引用次数: 0

Assessment of comorbidity awareness in patients with atrial fibrillation: The ACAPAF study 房颤患者合并症意识评估：ACAPAF研究

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-12-01 Epub Date: 2025-10-02 DOI: 10.1016/j.ijcha.2025.101813

Rana Önder , Lien Desteghe , Johan Vijgen , Hein Heidbuchel

Background and aim

Systematic and integrated comorbidity management in patients with atrial fibrillation (AF) requires patient involvement, starting with comorbidity awareness. This study evaluates comorbidity awareness in patients with AF before and after a first nurse-led AF clinic visit and after six months. We also measured the time needed for full comorbidity mapping using the EHRA-PATHS software.

Methods

This prospective two-centre study included patients diagnosed with AF attending the AF clinic for the first time. The software systematically assessed 23 comorbidities. Patients completed a comorbidity awareness questionnaire, focusing on nine AF-related comorbidities two weeks before their first visit, less than a week after, and six months later. Patients also had a telephone consultation with the AF nurse to discuss their comorbidities 1–3 months post-visit.

Results

The study included 76 patients (mean age 68.3 ± 10.3 y). Baseline awareness of comorbidity relevance for AF ranged between 11.1–100.0 %. Awareness about own alcohol consumption was the most ‘underestimated’ comorbidity before first contact (50.0 %), while smoking was most ‘overestimated’ (55.6 %; i.e. admitted in private but not during formal evaluation by nurses). The impact of an AF clinic visit on awareness of personal comorbidities was limited (p = 0.456), and also after an additional phone consultation, awareness was suboptimal after six months (p = 0.099). AF nurses needed 18.4 ± 8.7 min to complete the software.

Conclusions

Patients’ comorbidity awareness is moderate, and more educational efforts are needed to improve their awareness. A systematic and complete comorbidity evaluation at the AF clinic using EHRA-PATHS software can be done within a reasonable time frame.

背景与目的房颤（AF）患者系统、综合的合并症管理需要患者的参与，从合并症意识开始。本研究评估了房颤患者在第一次护士主导的房颤门诊就诊前后和6个月后的合并症意识。我们还测量了使用EHRA-PATHS软件绘制完整共病图所需的时间。方法本前瞻性双中心研究纳入首次就诊的房颤患者。该软件系统地评估了23种合并症。患者在首次就诊前两周、就诊后不到一周和6个月完成了一份合并症意识问卷，重点关注9种房颤相关合并症。访视后1-3个月，患者与房颤护士进行电话咨询，讨论其合并症。结果共纳入76例患者，平均年龄68.3±10.3岁。对房颤合并症相关性的基线认知在11.1 - 100.0%之间。在第一次接触之前，对自己饮酒的认识是最被“低估”的共病（50.0%），而吸烟是最被“高估”的（55.6%；即私下承认，但没有在护士的正式评估期间）。房颤门诊就诊对个人合并症意识的影响有限（p = 0.456），而且在额外的电话咨询后，六个月后的意识也不理想（p = 0.099）。房颤护士完成软件的时间为18.4±8.7 min。结论患者的合并症知晓率一般，需加大教育力度提高合并症知晓率。在合理的时间框架内，使用EHRA-PATHS软件在房颤诊所进行系统和完整的合并症评估。

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引用次数: 0

Distribution of coronary artery calcium in a large European all-comer population referred for cardiac imaging 冠状动脉钙的分布在一个大的欧洲所有角落的人群参考心脏成像

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.2025.101792

Julia Duelli, Christoph Ryffel, Magdalena Stuetz, Raffael Ghenzi, Marko Gajic, Dimitrios Moysidis, Dominik C. Benz, Aju P. Pazhenkottil, Andreas A. Giannopoulos, Philipp A. Kaufmann, Ronny R. Buechel

Background and aims

The coronary artery calcium score (CACS) is a well-established surrogate marker of atherosclerotic plaque burden and is highly valuable for risk stratification. However, contemporary data on the distribution of CACS across age and sex is lacking, particularly for European countries and quantified by multi-slice CT. We assessed predictors of CACS and provide granular age- and sex-specific reference values derived from a real-world clinical population referred for cardiac imaging.

Methods

This single-center, retrospective study examined patients clinically referred for non-invasive cardiac imaging from May 2013 to May 2024. Patients without coronary artery disease, cardiomyopathy, cardiac surgery or intervention, renal or hepatic failure were included. Multiple linear regression was used to identify independent predictors of CACS, and predictor importance was calculated. CACS percentiles were then calculated for both sexes and stratified across nine age groups.

Results

The final population consisted of 18′225 individuals (39.6 % women; 60.8 % symptomatic). Age and sex were the most influential predictors of CACS, accounting for 69 % and 18 % relative predictor importance, respectively. Men exhibited a significantly higher median CACS than women (59 [IQR 1–338] vs. 10 [IQR 0–129], p < 0.001) across all age groups.

Conclusions

This study provides contemporary age- and sex-based CAC score reference values, as observed in a large European real-world cohort referred for cardiac imaging. Age and sex exhibit the most relevant impact on expected CAC scores, while other conventional risk factors appear to be less important. Our results enable improved classification regarding the coronary calcium burden.

背景和目的冠状动脉钙评分（CACS）是一种公认的动脉粥样硬化斑块负荷的替代指标，在危险分层中具有很高的价值。然而，关于CACS跨年龄和性别分布的当代数据缺乏，特别是在欧洲国家，并通过多层CT量化。我们评估了CACS的预测因素，并提供了来自真实世界临床人群的年龄和性别特异性参考值。方法本研究为单中心、回顾性研究，选取2013年5月至2024年5月间临床转诊的无创心脏影像学患者。没有冠状动脉疾病、心肌病、心脏手术或干预、肾脏或肝功能衰竭的患者被包括在内。采用多元线性回归识别CACS的独立预测因子，并计算预测因子重要性。然后计算男女的CACS百分位数，并在9个年龄组中分层。结果最终人群共18225例，其中女性39.6%，有症状者60.8%。年龄和性别是CACS最重要的预测因素，分别占69%和18%的相对预测重要性。在所有年龄组中，男性的中位CACS明显高于女性（59 [IQR 1-338]对10 [IQR 0-129]， p < 0.001）。结论：本研究提供了当代基于年龄和性别的CAC评分参考值，这是在一个大型欧洲真实世界队列中观察到的。年龄和性别对预期CAC评分的影响最大，而其他传统的风险因素似乎不太重要。我们的结果使冠状动脉钙负荷的分类得到改进。

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引用次数: 0

Recent highlights from the International Journal of Cardiology: Heart & Vasculature: Valvular heart disease 《国际心脏病学杂志》近期重点报道：心脏与血管系统：瓣膜性心脏病

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-12-01 Epub Date: 2025-10-24 DOI: 10.1016/j.ijcha.2025.101828

Francesco Pelliccia, Artur Dziewierz, Marco Zimarino, Dobromir Dobrev

引用次数: 0