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。
{"title":"Clinical utility of segmental native T1 mapping for diagnosis and risk-stratification in cardiac sarcoidosis","authors":"Hidehiro Iwakawa , Nobuhiro Suzuki , Hirokazu Yoshida , Yohei Sasaki , Ryosuke Kato , Ryota Kaimori , Hiroyuki Watanabe","doi":"10.1016/j.ijcha.2025.101787","DOIUrl":"10.1016/j.ijcha.2025.101787","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>P</em> < 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 %, <em>P</em> = 0.028).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101787"},"PeriodicalIF":2.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144917251","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}
Pub Date : 2025-08-28DOI: 10.1016/j.ijcha.2025.101782
Eric Katsuyama , Christian Fukunaga , Felipe S. Passos , Nicole Lee , Ana Carolina Ventura de Santana de Jesus , Camila M. Ydy , Sofia Junqueira Franco Massuda , Hristo Kirov , Torsten Doenst , Tulio Caldonazo
Introduction
Tricuspid valve infective endocarditis (TVIE) is surgically managed by tricuspid valve repair (TVr) or replacement (TVR). However, the differences in long-term endpoints and perioperative complications between the two strategies remain unclear. Therefore, this updated meta-analysis aimed to evaluate the efficacy and safety of TVr compared with TVR.
Methods
MEDLINE, EMBASE, Cochrane Library, LILACS, and ClinicalTrials.gov were searched. The endpoints of interest were long-term all-cause mortality (primary), any reoperation, reinfection, postoperative stroke, and postoperative acute kidney injury (AKI). Data are reported as hazard ratios (HR) and odds ratios (OR) with their respective 95% confidence intervals (CI).
Results
We included 19 retrospective cohorts comprising 9,734 patients, of which 59.7 % received TVr and 74.3 % were intravenous drug users. One study was risk-adjusted. The median age and follow-up were 35.9 years and 3.9 years, respectively. Compared with TVR, TVr was associated with lower long-term mortality (HR: 0.77; 95 %CI: 0.60 to 0.98; P = 0.04) and lower odds of any reoperation (OR: 0.73; 95 %CI: 0.60 to 0.89; P < 0.01), reinfection (OR: 0.40; 95 %CI: 0.19 to 0.86; P = 0.02), and postoperative AKI (OR: 0.79; 95 %CI: 0.68 to 0.92; P < 0.01). No differences were found in postoperative stroke (OR: 1.17; 95 %CI: 0.83 to 1.65; P = 0.41).
Conclusion
In this meta-analysis, TVr improved overall survival and reduced postoperative complications in patients with TVIE. A possible treatment allocation bias needs to be considered as a potential concern of series with observational nature.
三尖瓣感染性心内膜炎（TVIE）通过三尖瓣修复（TVr）或置换术（TVr）进行手术治疗。然而，两种策略在长期终点和围手术期并发症方面的差异尚不清楚。因此，这项更新的荟萃分析旨在评估TVr与TVr的疗效和安全性。方法检索medline、EMBASE、Cochrane Library、LILACS和ClinicalTrials.gov。感兴趣的终点是长期全因死亡率（主要），任何再手术，再感染，术后卒中和术后急性肾损伤（AKI）。数据以风险比（HR）和优势比（OR）及其各自的95%置信区间（CI）报告。结果纳入19个回顾性队列，共9734例患者，其中59.7%接受TVr治疗，74.3%为静脉吸毒者。一项研究是风险调整的。中位年龄和随访时间分别为35.9岁和3.9岁。与TVR相比，TVR与较低的长期死亡率（HR: 0.77; 95% CI: 0.60 ~ 0.98; P = 0.04）、较低的再手术几率（OR: 0.73; 95% CI: 0.60 ~ 0.89; P < 0.01）、再感染（OR: 0.40; 95% CI: 0.19 ~ 0.86; P = 0.02）和术后AKI （OR: 0.79; 95% CI: 0.68 ~ 0.92; P < 0.01）相关。术后卒中发生率无差异（OR: 1.17; 95% CI: 0.83 ~ 1.65; P = 0.41）。结论：在这项荟萃分析中，TVr提高了TVIE患者的总生存率，减少了术后并发症。一个可能的治疗分配偏倚需要考虑作为一个潜在的关注系列具有观察性。
{"title":"Long-term outcomes of surgical repair versus replacement for tricuspid valve endocarditis − A meta-analysis of reconstructed time-to-event data","authors":"Eric Katsuyama , Christian Fukunaga , Felipe S. Passos , Nicole Lee , Ana Carolina Ventura de Santana de Jesus , Camila M. Ydy , Sofia Junqueira Franco Massuda , Hristo Kirov , Torsten Doenst , Tulio Caldonazo","doi":"10.1016/j.ijcha.2025.101782","DOIUrl":"10.1016/j.ijcha.2025.101782","url":null,"abstract":"<div><h3>Introduction</h3><div>Tricuspid valve infective endocarditis (TVIE) is surgically managed by tricuspid valve repair (TVr) or replacement (TVR). However, the differences in long-term endpoints and perioperative complications between the two strategies remain unclear. Therefore, this updated <em>meta</em>-analysis aimed to evaluate the efficacy and safety of TVr compared with TVR.</div></div><div><h3>Methods</h3><div>MEDLINE, EMBASE, Cochrane Library, LILACS, and ClinicalTrials<span><span>.gov</span><svg><path></path></svg></span> were searched. The endpoints of interest were long-term all-cause mortality (primary), any reoperation, reinfection, postoperative stroke, and postoperative acute kidney injury (AKI). Data are reported as hazard ratios (HR) and odds ratios (OR) with their respective 95% confidence intervals (CI).</div></div><div><h3>Results</h3><div>We included 19 retrospective cohorts comprising 9,734 patients, of which 59.7 % received TVr and 74.3 % were intravenous drug users. One study was risk-adjusted. The median age and follow-up were 35.9 years and 3.9 years, respectively. Compared with TVR, TVr was associated with lower long-term mortality (HR: 0.77; 95 %CI: 0.60 to 0.98; P = 0.04) and lower odds of any reoperation (OR: 0.73; 95 %CI: 0.60 to 0.89; P < 0.01), reinfection (OR: 0.40; 95 %CI: 0.19 to 0.86; P = 0.02), and postoperative AKI (OR: 0.79; 95 %CI: 0.68 to 0.92; P < 0.01). No differences were found in postoperative stroke (OR: 1.17; 95 %CI: 0.83 to 1.65; P = 0.41).</div></div><div><h3>Conclusion</h3><div>In this <em>meta</em>-analysis, TVr improved overall survival and reduced postoperative complications in patients with TVIE. A possible treatment allocation bias needs to be considered as a potential concern of series with observational nature.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101782"},"PeriodicalIF":2.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913550","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}
Pub Date : 2025-08-28DOI: 10.1016/j.ijcha.2025.101781
Tulio Caldonazo , Marcus Winter , Michael Kiehntopf , René Aschenbach , Stephanie Gräger , Sebastian Reinartz , André Scherag , Ulrike Schumacher , Hristo Kirov , Ulf Teichgräber , Torsten Doenst , on behalf of the RORSCHACH Investigators and GermaN HeaRTS
Background
Cardiac biomarkers are important components for diagnosing perioperative myocardial infarction (MI). Efforts to detect MI by biomarker-release only faced heavy criticism, because cardiac biomarker-release has also been observed in situations that are not always related to cell death (e.g., renal insufficiency, neurological diseases, and even after endurance exercise). This study correlates release patterns of all three classically used cardiac injury biomarkers (CK/CK-MB, Troponin T and I) with myocardial damage visualized by late gadolinium enhanced cardiac magnetic resonance imaging (LGE-cMRI) and also compares biomarkers among each other.
Methods and analysis
The RORSCHACH study is a prospective, multicenter, single-armed, non-blinded, non-controlled study evaluating cardiac biomarker release during elective aortic or mitral valve surgery and their correlation to perioperative myocardial damage as detected by MRI. Enrolled patients undergo routine monitoring including echocardiography, electrocardiography, cardiac biomarker analyses, and clinical symptom assessment preoperatively (within 24 h prior to surgery) and postoperative at predefined timepoints. LGE-cMRI is performed preoperatively and at least 5 days after surgery to clinically quantify any new myocardial damage. In total, 100 patients will be enrolled, whereby a drop-out rate of 15 % subsequently results in 85 patients necessary for final analysis. The primary endpoint is the correlation of the peak value of the respective biomarker with the amount of perioperatively induced myocardial damage quantified by LGE-cMRI.
Discussion
The RORSCHACH trial will deliver the first comparative and quantitative information on the predictive value of the three classic cardiac injury markers used for the detection of new perioperative irreversible injury/MI in cardiac surgery.
Study registration
Clinicaltrials.gov. NCT06066970. Registered on September 28th 2023.
{"title":"Cardiac biomarkers for the quantification of myocardial damage after cardiac surgery – The RORSCHACH trial","authors":"Tulio Caldonazo , Marcus Winter , Michael Kiehntopf , René Aschenbach , Stephanie Gräger , Sebastian Reinartz , André Scherag , Ulrike Schumacher , Hristo Kirov , Ulf Teichgräber , Torsten Doenst , on behalf of the RORSCHACH Investigators and GermaN HeaRTS","doi":"10.1016/j.ijcha.2025.101781","DOIUrl":"10.1016/j.ijcha.2025.101781","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac biomarkers are important components for diagnosing perioperative myocardial infarction (MI). Efforts to detect MI by biomarker-release only faced heavy criticism, because cardiac biomarker-release has also been observed in situations that are not always related to cell death (e.g., renal insufficiency, neurological diseases, and even after endurance exercise). This study correlates release patterns of all three classically used cardiac injury biomarkers (CK/CK-MB, Troponin T and I) with myocardial damage visualized by late gadolinium enhanced cardiac magnetic resonance imaging (LGE-cMRI) and also compares biomarkers among each other.</div></div><div><h3>Methods and analysis</h3><div>The RORSCHACH study is a prospective, multicenter, single-armed, non-blinded, non-controlled study evaluating cardiac biomarker release during elective aortic or mitral valve surgery and their correlation to perioperative myocardial damage as detected by MRI. Enrolled patients undergo routine monitoring including echocardiography, electrocardiography, cardiac biomarker analyses, and clinical symptom assessment preoperatively (within 24 h prior to surgery) and postoperative at predefined timepoints. LGE-cMRI is performed preoperatively and at least 5 days after surgery to clinically quantify any new myocardial damage. In total, 100 patients will be enrolled, whereby a drop-out rate of 15 % subsequently results in 85 patients necessary for final analysis. The primary endpoint is the correlation of the peak value of the respective biomarker with the amount of perioperatively induced myocardial damage quantified by LGE-cMRI.</div></div><div><h3>Discussion</h3><div>The RORSCHACH trial will deliver the first comparative and quantitative information on the predictive value of the three classic cardiac injury markers used for the detection of new perioperative irreversible injury/MI in cardiac surgery.</div></div><div><h3>Study registration</h3><div><span><span>Clinicaltrials.gov</span><svg><path></path></svg></span>. NCT06066970. Registered on September 28th 2023.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101781"},"PeriodicalIF":2.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907690","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}
Pub Date : 2025-08-27DOI: 10.1016/j.ijcha.2025.101780
Anke Fender , Florian Bruns , Dobromir Dobrev
{"title":"Recent highlights from the International Journal of Cardiology Heart and Vasculature: cardio-oncology","authors":"Anke Fender , Florian Bruns , Dobromir Dobrev","doi":"10.1016/j.ijcha.2025.101780","DOIUrl":"10.1016/j.ijcha.2025.101780","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101780"},"PeriodicalIF":2.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902504","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}
Pub Date : 2025-08-26DOI: 10.1016/j.ijcha.2025.101776
Tijmen H. Ris , Morsal Atazadah , Roel Hoek , Jeroen Hoogland , Tim Balthazar , Federico Pappalardo , Paul Knaapen , Mariëlle C. van de Veerdonk , Alexander Nap
Background
The Cardiogenic Shock Working Group-modified Society for Cardiovascular Angiography and Interventions (CSWG-SCAI) has been validated in patients with cardiogenic shock (CS) related to heart failure (HF). Its prognostic value in patients with early-stage HF-CS has been scarcely investigated.
Methods
In 208 patients with HF-CS, the relationship between the CSWG-SCAI stage at diagnosis, at 24 and 48 h, the maximum CSWG-SCAI stage, and in-hospital mortality were assessed. In addition, the added value of urine output (UO) to the CSWG-SCAI was evaluated.
Results
At HF-CS diagnosis, stages A and B were most prevalent (33 % and 36 %), while stage C dominated at 24 h (51 %), 48 h (44 %) and maximum CSWG-SCAI (37 %). In total, 87 (42 %) patients died during hospitalization. At HF-CS diagnosis, lower stages (A/B) showed similar prognostic value compared to more severe stages (C/D/E) (p = 0.994). The CSWG-SCAI was associated with in-hospital mortality at 24 h (p = 0.005), 48 h (p = 0.005) and at maximum CSWG SCAI (p < 0.001). Stage deterioration after 24 h was associated with mortality (deteriorated vs. improved: p < 0.001). SCAI-UO showed modest additive predictive value at 48 h (AUC 0.67 vs. AUC 0.70; p = 0.015) and maximum SCAI compared to CSWG-SCAI (AUC 0.66 vs. AUC 0.69; p = 0.032).
Conclusions
At the time of HF-CS diagnosis, the CSWG-SCAI classification failed to predict in-hospital mortality, suggesting that it may not adequately capture the severity of early-stage HF-CS. The CSWG-SCAI classification was associated with in-hospital mortality at 24 and 48 h and at maximum CSWG-SCAI. Incorporating UO into the CSWG-SCAI criteria minimally improved risk stratification.
心源性休克工作组修改的心血管血管造影与干预学会（CSWG-SCAI）已在心力衰竭（HF）相关的心源性休克（CS）患者中得到验证。其对早期HF-CS患者的预后价值研究甚少。方法分析208例HF-CS患者诊断时CSWG-SCAI分期、24、48 h CSWG-SCAI最高分期与住院死亡率的关系。此外，还评估了尿量（UO）对CSWG-SCAI的附加值。结果HF-CS诊断以A期和B期为主（33%和36%），C期以24 h（51%）、48 h（44%）和最大CSWG-SCAI（37%）为主。共有87例（42%）患者在住院期间死亡。在诊断HF-CS时，较低分期（A/B）与较严重分期（C/D/E）的预后价值相似（p = 0.994）。CSWG-SCAI与24小时（p = 0.005）、48小时（p = 0.005）和最大CSWG SCAI时的住院死亡率相关（p < 0.001）。24小时后分期恶化与死亡率相关（恶化vs.改善：p <； 0.001）。与CSWG-SCAI相比，SCAI- uo在48 h时表现出适度的加性预测值（AUC 0.67 vs AUC 0.70, p = 0.015）， SCAI最大（AUC 0.66 vs AUC 0.69, p = 0.032）。结论在诊断HF-CS时，CSWG-SCAI分级不能预测院内死亡率，提示其可能不能充分反映早期HF-CS的严重程度。CSWG-SCAI分级与24小时和48小时以及最大CSWG-SCAI时的住院死亡率相关。将UO纳入CSWG-SCAI标准，最低限度地改善了风险分层。
{"title":"Predictive value of the cardiogenic shock working group-modified SCAI criteria in early-stage heart failure-related cardiogenic shock","authors":"Tijmen H. Ris , Morsal Atazadah , Roel Hoek , Jeroen Hoogland , Tim Balthazar , Federico Pappalardo , Paul Knaapen , Mariëlle C. van de Veerdonk , Alexander Nap","doi":"10.1016/j.ijcha.2025.101776","DOIUrl":"10.1016/j.ijcha.2025.101776","url":null,"abstract":"<div><h3>Background</h3><div>The Cardiogenic Shock Working Group-modified Society for Cardiovascular Angiography and Interventions (CSWG-SCAI) has been validated in patients with cardiogenic shock (CS) related to heart failure (HF). Its prognostic value in patients with early-stage HF-CS has been scarcely investigated.</div></div><div><h3>Methods</h3><div>In 208 patients with HF-CS, the relationship between the CSWG-SCAI stage at diagnosis, at 24 and 48 h, the maximum CSWG-SCAI stage, and in-hospital mortality were assessed. In addition, the added value of urine output (UO) to the CSWG-SCAI was evaluated.</div></div><div><h3>Results</h3><div>At HF-CS diagnosis, stages A and B were most prevalent (33 % and 36 %), while stage C dominated at 24 h (51 %), 48 h (44 %) and maximum CSWG-SCAI (37 %). In total, 87 (42 %) patients died during hospitalization. At HF-CS diagnosis, lower stages (A/B) showed similar prognostic value compared to more severe stages (C/D/E) (p = 0.994). The CSWG-SCAI was associated with in-hospital mortality at 24 h (p = 0.005), 48 h (p = 0.005) and at maximum CSWG SCAI (p < 0.001). Stage deterioration after 24 h was associated with mortality (deteriorated vs. improved: p < 0.001). SCAI-UO showed modest additive predictive value at 48 h (AUC 0.67 vs. AUC 0.70; p = 0.015) and maximum SCAI compared to CSWG-SCAI (AUC 0.66 vs. AUC 0.69; p = 0.032).</div></div><div><h3>Conclusions</h3><div>At the time of HF-CS diagnosis, the CSWG-SCAI classification failed to predict in-hospital mortality, suggesting that it may not adequately capture the severity of early-stage HF-CS. The CSWG-SCAI classification was associated with in-hospital mortality at 24 and 48 h and at maximum CSWG-SCAI. Incorporating UO into the CSWG-SCAI criteria minimally improved risk stratification.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101776"},"PeriodicalIF":2.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895917","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}
Pub Date : 2025-08-25DOI: 10.1016/j.ijcha.2025.101785
Elgin Ozkan , Liya Dai , Farrokh Dehdashti , Kan Liu , Thomas H. Schindler
Background
To investigate the relationship between coronary vasodilator capacity, left ventricular hypertrophy, and regional myocardial function in two different disease entities of obese (OB) and morbidly obese (MOB) individuals.
Methods
13N-ammonia PET/CT determined myocardial blood flow (MBF) at rest and during pharmacologically induced hyperemia, and corresponding myocardial flow reserve (MFR) with 13N-ammonia PET/CT. Left ventricular mass (LVM), early diastolic flow (E), relaxation (e’) velocities, and global longitudinal strain (GLS) were acquired with 2D, trans-mitral Doppler and tissue Doppler, and speckle tracking echocardiography, respectively. Patients were then grouped according to the body mass index (BMI) into normal weight (NW: BMI 20.0–24.9 kg/m2, n = 27), overweight (OW: BMI 25.0–29.9 kg/ m2, n = 31), obesity (OB: BMI 30.0–39.9 kg/m2, n = 71), and morbid obesity (MOB: BMI ≥ 40 kg/m2, n = 97).
Results
MFR progressively decreased from NW, OW, to OB (2.71 ± 0.84 vs. 2.50 ± 0.67 and 2.33 ± 0.63; p ≤ 0.04 by ANOVA), while it increased again in MOB comparable to NW (2.51 ± 0.51 vs. 2.71 ± 0.84, p = 0.70). In OB and MOB, MFR was inversely correlated with E velocity (cm/s), respectively (r = 0.32, SEE = 0.58, p = 0.02; and r = 0.29, SEE = 0.47, p = 0.02). Conversely, LVM, and GLS associated significantly and inversely with the MFR in OB (r = 0.27, SEE = 0.59, p = 0.05; and r = 0.31, SEE = 0.61, p = 0.04), but not in MOB, respectively (r = 0.13, SEE = 0.49, p = 0.27; and r = 0.05, SEE = 0.54, p = 0.73). Notably, GLS, E-velocity, and LVM remained independent predictors of MFR.
Conclusion
Divergent associations of coronary vasodilator capacity with left ventricular mass and early myocardial contractile dysfunction outline OB and MOB to affect left ventricular remodeling differently.
研究肥胖（OB）和病态肥胖（MOB）两种不同疾病个体冠状动脉血管舒张容量、左心室肥厚和局部心肌功能之间的关系。方法13n -氨PET/CT测定静息和药理学诱导充血时心肌血流量（MBF）及相应的心肌血流储备（MFR）。分别采用二维超声心动图、经二尖瓣多普勒超声心动图、组织多普勒超声心动图和斑点跟踪超声心动图获取左室质量（LVM）、舒张早期血流(E)、舒张速度（E′）和总纵应变（GLS）。然后根据体重指数（BMI）将患者分为正常体重（NW: BMI 20.0 ~ 24.9 kg/m2, n = 27）、超重（OW: BMI 25.0 ~ 29.9 kg/m2, n = 31）、肥胖（OB: BMI 30.0 ~ 39.9 kg/m2, n = 71）和病态肥胖（MOB: BMI≥40 kg/m2, n = 97）。结果从NW、OW到OB， smfr逐渐降低（2.71±0.84∶2.50±0.67∶2.33±0.63；方差分析p≤0.04），而与NW相比，MOB的smfr再次升高（2.51±0.51∶2.71±0.84,p = 0.70）。在OB和MOB中，MFR分别与E速度（cm/s）呈负相关（r = 0.32, SEE = 0.58, p = 0.02; r = 0.29, SEE = 0.47, p = 0.02）。相反，LVM和GLS与OB的MFR呈显著负相关（r = 0.27, SEE = 0.59, p = 0.05; r = 0.31, SEE = 0.61, p = 0.04），而MOB与MFR无显著负相关（r = 0.13, SEE = 0.49, p = 0.27; r = 0.05, SEE = 0.54, p = 0.73）。值得注意的是，GLS、E-velocity和LVM仍然是MFR的独立预测因子。结论冠状动脉血管扩张剂容量与左室质量和早期心肌收缩功能障碍的不同相关性表明OB和MOB对左室重构的影响不同。
{"title":"Coronary vasodilator capacity in obesity and morbid obesity – divergent flow responses with left ventricular hypertrophy","authors":"Elgin Ozkan , Liya Dai , Farrokh Dehdashti , Kan Liu , Thomas H. Schindler","doi":"10.1016/j.ijcha.2025.101785","DOIUrl":"10.1016/j.ijcha.2025.101785","url":null,"abstract":"<div><h3>Background</h3><div>To investigate the relationship between coronary vasodilator capacity, left ventricular hypertrophy, and regional myocardial function in two different disease entities of obese (OB) and morbidly obese (MOB) individuals.</div></div><div><h3>Methods</h3><div><sup>13</sup>N-ammonia PET/CT determined myocardial blood flow (MBF) at rest and during pharmacologically induced hyperemia, and corresponding myocardial flow reserve (MFR) with <sup>13</sup>N-ammonia PET/CT. Left ventricular mass (LVM), early diastolic flow (E), relaxation (e’) velocities, and global longitudinal strain (GLS) were acquired with 2D, <em>trans</em>-mitral Doppler and tissue Doppler, and speckle tracking echocardiography, respectively. Patients were then grouped according to the body mass index (BMI) into normal weight (NW: BMI 20.0–24.9 kg/m<sup>2</sup>, n = 27), overweight (OW: BMI 25.0–29.9 kg/ m<sup>2</sup>, n = 31), obesity (OB: BMI 30.0–39.9 kg/m<sup>2</sup>, n = 71), and morbid obesity (MOB: BMI ≥ 40 kg/m<sup>2</sup>, n = 97).</div></div><div><h3>Results</h3><div>MFR progressively decreased from NW, OW, to OB (2.71 ± 0.84 vs. 2.50 ± 0.67 and 2.33 ± 0.63; p ≤ 0.04 by ANOVA), while it increased again in MOB comparable to NW (2.51 ± 0.51 vs. 2.71 ± 0.84, p = 0.70). In OB and MOB, MFR was inversely correlated with E velocity (cm/s), respectively (r = 0.32, SEE = 0.58, p = 0.02; and r = 0.29, SEE = 0.47, p = 0.02). Conversely, LVM, and GLS associated significantly and inversely with the MFR in OB (r = 0.27, SEE = 0.59, p = 0.05; and r = 0.31, SEE = 0.61, p = 0.04), but not in MOB, respectively (r = 0.13, SEE = 0.49, p = 0.27; and r = 0.05, SEE = 0.54, p = 0.73). Notably, GLS, E-velocity, and LVM remained independent predictors of MFR.</div></div><div><h3>Conclusion</h3><div>Divergent associations of coronary vasodilator capacity with left ventricular mass and early myocardial contractile dysfunction outline OB and MOB to affect left ventricular remodeling differently.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101785"},"PeriodicalIF":2.5,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893010","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}
Pub Date : 2025-08-21DOI: 10.1016/j.ijcha.2025.101775
Sher May Ng , Geert H.D. Voordes , Michelle Lobeek , Michiel Rienstra , Adriaan A. Voors , Elke S. Hoendermis , Dirk J. van Veldhuisen , Thomas M. Gorter
Background
Right ventricular (RV) dysfunction (RVD) in heart failure (HF) with preserved ejection fraction (HFpEF) is recognised late and associated with poor outcomes. We aimed to identify biomarkers associated with RV dysfunction in HFpEF and evaluate their prognostic significance.
Methods
77 patients with HFpEF were enrolled from a prospective, multicentre study. At baseline, patients underwent echocardiography, cardiac magnetic resonance (CMR) imaging and laboratory testing. They were followed up for the composite outcome parameter of all-cause mortality and HF hospitalisation. RVD was defined as RV ejection fraction (RVEF) < 45 % on CMR. Proteomics analysis was performed using Olink proteomics multiplex panels (CVDII, CVDIII, Inflammatory and Immuno-oncology) with further verification on immunoassay analysis.
Results
19 patients with HFpEF (25 %) had RVD. The Olink proteomic analysis identified carbohydrate antigen 125 (CA125) as the most differentially abundant in plasma of patients with HFpEF and RVD as compared to those without RVD, which corroborated with further immunoassay analysis − median CA125 in patients with RVD was 23 kU/L [21–47] vs. 16 [[12], [13], [14], [15], [16], [17], [18], [19], [20]] in patients without RVD (p < 0.001). Log-normalised CA125 (LnCA125) was associated with worse RVEF (r = −0.29, p = 0.03) and predicted worse clinical outcomes [HR 2.28 (1.28–4.07) for the composite outcome of all-cause mortality and HF hospitalisation] adjusted for age, gender, body mass index, LVEF, RVD, atrial fibrillation, renal function and NTproBNP.
Conclusion
Targeted proteomic analysis reveals CA125 as a biomarker for RVD in a HFpEF population. Higher serum CA125 concentration, but not NTproBNP, was associated with an increased risk of all-cause mortality and HF hospitalisation.
{"title":"Carbohydrate antigen-125 (CA125): a marker of right ventricular dysfunction and poor prognosis in heart failure with preserved ejection fraction","authors":"Sher May Ng , Geert H.D. Voordes , Michelle Lobeek , Michiel Rienstra , Adriaan A. Voors , Elke S. Hoendermis , Dirk J. van Veldhuisen , Thomas M. Gorter","doi":"10.1016/j.ijcha.2025.101775","DOIUrl":"10.1016/j.ijcha.2025.101775","url":null,"abstract":"<div><h3>Background</h3><div>Right ventricular (RV) dysfunction (RVD) in heart failure (HF) with preserved ejection fraction (HFpEF) is recognised late and associated with poor outcomes. We aimed to identify biomarkers associated with RV dysfunction in HFpEF and evaluate their prognostic significance.</div></div><div><h3>Methods</h3><div>77 patients with HFpEF were enrolled from a prospective, multicentre study. At baseline, patients underwent echocardiography, cardiac magnetic resonance (CMR) imaging and laboratory testing. They were followed up for the composite outcome parameter of all-cause mortality and HF hospitalisation. RVD was defined as RV ejection fraction (RVEF) < 45 % on CMR. Proteomics analysis was performed using Olink proteomics multiplex panels (CVDII, CVDIII, Inflammatory and Immuno-oncology) with further verification on immunoassay analysis.</div></div><div><h3>Results</h3><div>19 patients with HFpEF (25 %) had RVD. The Olink proteomic analysis identified carbohydrate antigen 125 (CA125) as the most differentially abundant in plasma of patients with HFpEF and RVD as compared to those without RVD, which corroborated with further immunoassay analysis − median CA125 in patients with RVD was 23 kU/L [21–47] vs. 16 [<span><span>[12]</span></span>, <span><span>[13]</span></span>, <span><span>[14]</span></span>, <span><span>[15]</span></span>, <span><span>[16]</span></span>, <span><span>[17]</span></span>, <span><span>[18]</span></span>, <span><span>[19]</span></span>, <span><span>[20]</span></span>] in patients without RVD (p < 0.001). Log-normalised CA125 (LnCA125) was associated with worse RVEF (r = −0.29, p = 0.03) and predicted worse clinical outcomes [HR 2.28 (1.28–4.07) for the composite outcome of all-cause mortality and HF hospitalisation] adjusted for age, gender, body mass index, LVEF, RVD, atrial fibrillation, renal function and NTproBNP.</div></div><div><h3>Conclusion</h3><div>Targeted proteomic analysis reveals CA125 as a biomarker for RVD in a HFpEF population. Higher serum CA125 concentration, but not NTproBNP, was associated with an increased risk of all-cause mortality and HF hospitalisation.</div><div>Word Count: 249.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101775"},"PeriodicalIF":2.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879596","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}
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