The ratio between early mitral flow wave to early diastolic mitral annulus velocity (E/e’ ratio) varies according to age and sex and is associated with mortality in heart failure. We sought to describe the association between E/e’ and mortality in patients with no apparent structural or functional cardiac abnormality and explore possible modifiers of this association.
Methods
A retrospective study of 104,315 patients who underwent echocardiographic evaluation during 2009-2021 in the largest tertiary center in Israel. Patients with cancer, ventricular dysfunction, significant valvular or structural heart disease, or evidence of pulmonary hypertension were excluded.
Results
The final analysis included 32,836 patients with a median age of 56 (43-66) years, and 13,547 (41%) were female. The median E/e’ was 8.3 (6.8-10.3), and 9,306 (28%) had an E/e’ >10. During a median follow-up of 5.7 (3.3-8.5) years, 2,396 (7.3%) individuals died. E/e’ >10 was associated with mortality (adjusted hazard ratio [HR] 1.16, 95% confidence interval [CI] 1.07-1.27, p<0.001). The mortality risk associated with E/e’ >10 was significantly higher in those aged ≤70 (HR 1.26, 95% CI 1.12-1.42, p<0.001), males (HR 1.34, 95% CI 1.19-1.49, p<0.001), a normal left ventricular mass (HR 1.13, 95% CI 1.02-1.24, p = 0.017), and pulmonary artery pressure <30 mmHg (HR 1.18, 95% CI 1.06-1.30, p = 0.003).
Conclusion
An elevated E/e’ is associated with mortality, specifically in younger individuals, males, and those with a normal left ventricular mass and lower pulmonary artery pressure. This suggests that an elevated E/e’ might be a marker of subclinical risk in these subgroups. Further studies are needed to identify whether an elevated E/e' is useful in shared decision-making regarding the management of cardiovascular risk factors.
{"title":"Modifiers of the Association between E/e' Ratio and Survival among Patients with No Apparent Structural or Functional Cardiac Abnormality","authors":"Yishay Wasserstrum , Rami Gilead , Sagit Ben-Zekry , Efrat Mazor-Dray , Anan Younis , Amit Segev , Elad Maor , Rafael Kuperstein","doi":"10.1016/j.hjc.2024.01.005","DOIUrl":"10.1016/j.hjc.2024.01.005","url":null,"abstract":"<div><h3>Background</h3><div>The ratio between early mitral flow wave to early diastolic mitral annulus velocity (E/e’ ratio) varies according to age and sex and is associated with mortality in heart failure. We sought to describe the association between E/e’ and mortality in patients with no apparent structural or functional cardiac abnormality and explore possible modifiers of this association.</div></div><div><h3>Methods</h3><div>A retrospective study of 104,315 patients who underwent echocardiographic evaluation during 2009-2021 in the largest tertiary center in Israel. Patients with cancer, ventricular dysfunction, significant valvular or structural heart disease, or evidence of pulmonary hypertension were excluded.</div></div><div><h3>Results</h3><div>The final analysis included 32,836 patients with a median age of 56 (43-66) years, and 13,547 (41%) were female. The median E/e’ was 8.3 (6.8-10.3), and 9,306 (28%) had an E/e’ >10. During a median follow-up of 5.7 (3.3-8.5) years, 2,396 (7.3%) individuals died. E/e’ >10 was associated with mortality (adjusted hazard ratio [HR] 1.16, 95% confidence interval [CI] 1.07-1.27, p<0.001). The mortality risk associated with E/e’ >10 was significantly higher in those aged ≤70 (HR 1.26, 95% CI 1.12-1.42, p<0.001), males (HR 1.34, 95% CI 1.19-1.49, p<0.001), a normal left ventricular mass (HR 1.13, 95% CI 1.02-1.24, p = 0.017), and pulmonary artery pressure <30 mmHg (HR 1.18, 95% CI 1.06-1.30, p = 0.003).</div></div><div><h3>Conclusion</h3><div>An elevated E/e’ is associated with mortality, specifically in younger individuals, males, and those with a normal left ventricular mass and lower pulmonary artery pressure. This suggests that an elevated E/e’ might be a marker of subclinical risk in these subgroups. Further studies are needed to identify whether an elevated E/e' is useful in shared decision-making regarding the management of cardiovascular risk factors.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 20-27"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139551739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01DOI: 10.1016/j.hjc.2024.02.002
Changhong Miao , Xinyi Xu , Shuoxuan Huang , Lingyi Kong , Zhiwei He , Yihan Wang , Kuang Chen , Lu Xiao
Background
Recent studies have highlighted a connection between gut microbiota and hypertension, yet the precise nature of this relationship remains unclear.
Objective
This research aims to analyze the causal link between gut microbiota and hypertension, along with associated complications, utilizing two-sample bidirectional Mendelian randomization (MR).
Materials and Methods
Summary data from genome-wide association studies (GWAS) meta-analyses, including gut microbiota GWAS data from 24 cohorts, and the latest GWAS data for hypertension-related conditions were acquired. Employing various MR methods, including Inverse-variance weighted (IVW), MR-Egger, Weighted Median, Simple Mode, and Weighted Mode, we investigated the association between gut microbiota and hypertension-related conditions. Sensitivity analyses were conducted for result stability, and reverse MR analysis assessed the potential for reverse causality.
Results
The Mendelian randomization analysis involving 199 microbial taxa and four phenotypes identified 46 microbial taxa with potential causal links to hypertension and its complications. Following Bonferroni correction, genus.Victivallis showed a robust causal relationship with hypertension (OR = 1.08, 95% CI = 1.04-1.12, P = 9.82e-5). This suggests an 8% increased risk of hypertension with each unit rise in genus.Victivallis abundance.
Conclusion
In conclusion, this study establishes a causal connection between gut microbiota and hypertension, along with common associated complications. The findings unveil potential targets and evidence for future hypertension and complication treatment through gut microbiota interventions, offering a novel avenue for therapeutic exploration.
{"title":"The Causality between Gut Microbiota and Hypertension and Hypertension-related Complications: A Bidirectional Two-Sample Mendelian Randomization Analysis","authors":"Changhong Miao , Xinyi Xu , Shuoxuan Huang , Lingyi Kong , Zhiwei He , Yihan Wang , Kuang Chen , Lu Xiao","doi":"10.1016/j.hjc.2024.02.002","DOIUrl":"10.1016/j.hjc.2024.02.002","url":null,"abstract":"<div><h3>Background</h3><div>Recent studies have highlighted a connection between gut microbiota and hypertension, yet the precise nature of this relationship remains unclear.</div></div><div><h3>Objective</h3><div>This research aims to analyze the causal link between gut microbiota and hypertension, along with associated complications, utilizing two-sample bidirectional Mendelian randomization (MR).</div></div><div><h3>Materials and Methods</h3><div>Summary data from genome-wide association studies (GWAS) meta-analyses, including gut microbiota GWAS data from 24 cohorts, and the latest GWAS data for hypertension-related conditions were acquired. Employing various MR methods, including Inverse-variance weighted (IVW), MR-Egger, Weighted Median, Simple Mode, and Weighted Mode, we investigated the association between gut microbiota and hypertension-related conditions. Sensitivity analyses were conducted for result stability, and reverse MR analysis assessed the potential for reverse causality.</div></div><div><h3>Results</h3><div>The Mendelian randomization analysis involving 199 microbial taxa and four phenotypes identified 46 microbial taxa with potential causal links to hypertension and its complications. Following Bonferroni correction, <em>genus.Victivallis</em> showed a robust causal relationship with hypertension (OR = 1.08, 95% CI = 1.04-1.12, P = 9.82e-5). This suggests an 8% increased risk of hypertension with each unit rise in <em>genus.Victivallis</em> abundance.</div></div><div><h3>Conclusion</h3><div>In conclusion, this study establishes a causal connection between gut microbiota and hypertension, along with common associated complications. The findings unveil potential targets and evidence for future hypertension and complication treatment through gut microbiota interventions, offering a novel avenue for therapeutic exploration.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 38-50"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139713465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01DOI: 10.1016/j.hjc.2024.02.006
Eleni Ntretsiou, Dimitris Benas, Paraskevi Trivilou, George Pavlidis, Ignatios Ikonomidis, Achilleas Attilakos, Efstathios Iliodromitis, Helen Triantafyllidi
Objective
Obesity and arterial hypertension (AH) in children represent well-recognized risk factors for cardiovascular (CV) events during adult life. We investigated any changes regarding several CV risk (CVR) factors in children after a 10-year follow-up period.
Methods
A cohort of 143 healthy children, elementary/high school students, 6–16 years old, was initially evaluated in 2010–2011 regarding CVR factors [obesity, blood pressure (BP), aortic stiffness (PWV), lipid profile] plus food habits/sports activity. At 10-years follow-up (2020–2021), 63/143 (44%) young adults were re-evaluated.
Results
Children with obesity (45%) had increased BP (p < 0.001) and a less favorable LDL-C/triglycerides profile (p = 0.001) compared to overweight/normoweight ones. In a 10-year follow-up, obesity and exercise improved (p < 0.001 and p = 0.005), systolic BP (SBP) (102 ± 13 vs. 118 ± 11 mmHg, p < 0.001) and PWV increased (6.1 ± 1 vs. 7.7 ± 1.1 m/sec, p < 0.001), LDL-C (96 ± 21 vs. 86 ± 24 mg/dl, p = 0.004) and HDL-C + (64 ± 18 vs. 55 ± 10 mg/dl, p < 0.001) decreased, triglycerides increased (62 ± 21 vs. 73 ± 34 mg/dl, p = 0.04), and food approached the western model of nutrition (less fish/fruits). In children/young adults, BMI was associated with age (Beta = 0.47, p < 0.001 and Beta = 0.36, p = 0.004), SBP (Beta = 0.46 and Beta = 0.52, p < 0.001), and LDL-C (Beta = 0.27 and Beta = 0.44, p < 0.001).
Conclusions
In children with obesity, increased BMI and waist circumference were related to SBP and a less favorable lipid profile. At the 10-year re-evaluation, obesity was partially improved, physical activity was increased, and SBP had reached the high-normal levels in a substantial number of young adults, while lipid profile was less favorable (for HDL-C/triglycerides) compared to baseline evaluation. Our results highlight the evolution of CVR factors from childhood to early adulthood.
{"title":"Evaluation of cardiovascular risk factors in children aged 6–16 years and their evolution in early adulthood in a 10-year follow-up study","authors":"Eleni Ntretsiou, Dimitris Benas, Paraskevi Trivilou, George Pavlidis, Ignatios Ikonomidis, Achilleas Attilakos, Efstathios Iliodromitis, Helen Triantafyllidi","doi":"10.1016/j.hjc.2024.02.006","DOIUrl":"10.1016/j.hjc.2024.02.006","url":null,"abstract":"<div><h3>Objective</h3><div>Obesity and arterial hypertension (AH) in children represent well-recognized risk factors for cardiovascular (CV) events during adult life. We investigated any changes regarding several CV risk (CVR) factors in children after a 10-year follow-up period.</div></div><div><h3>Methods</h3><div>A cohort of 143 healthy children, elementary/high school students, 6–16 years old, was initially evaluated in 2010–2011 regarding CVR factors [obesity, blood pressure (BP), aortic stiffness (PWV), lipid profile] plus food habits/sports activity. At 10-years follow-up (2020–2021), 63/143 (44%) young adults were re-evaluated.</div></div><div><h3>Results</h3><div>Children with obesity (45%) had increased BP (p < 0.001) and a less favorable LDL-C/triglycerides profile (p = 0.001) compared to overweight/normoweight ones. In a 10-year follow-up, obesity and exercise improved (p < 0.001 and p = 0.005), systolic BP (SBP) (102 ± 13 vs. 118 ± 11 mmHg, p < 0.001) and PWV increased (6.1 ± 1 vs. 7.7 ± 1.1 m/sec, p < 0.001), LDL-C (96 ± 21 vs. 86 ± 24 mg/dl, p = 0.004) and HDL-C + (64 ± 18 vs. 55 ± 10 mg/dl, p < 0.001) decreased, triglycerides increased (62 ± 21 vs. 73 ± 34 mg/dl, p = 0.04), and food approached the western model of nutrition (less fish/fruits). In children/young adults, BMI was associated with age (Beta = 0.47, p < 0.001 and Beta = 0.36, p = 0.004), SBP (Beta = 0.46 and Beta = 0.52, p < 0.001), and LDL-C (Beta = 0.27 and Beta = 0.44, p < 0.001).</div></div><div><h3>Conclusions</h3><div>In children with obesity, increased BMI and waist circumference were related to SBP and a less favorable lipid profile. At the 10-year re-evaluation, obesity was partially improved, physical activity was increased, and SBP had reached the high-normal levels in a substantial number of young adults, while lipid profile was less favorable (for HDL-C/triglycerides) compared to baseline evaluation. Our results highlight the evolution of CVR factors from childhood to early adulthood.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 60-70"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The increasing prevalence of cardiovascular diseases has led to the widespread use of cardiovascular drugs that can adversely impact glucose metabolism. This review focuses on the latest evidence on the potential of cardiovascular drugs to induce adverse glycemic effects but also the underlying mechanisms, prevention, and management strategies.
Materials and methods
A comprehensive literature search was conducted across scientific databases until May 25th, 2024.
Results
Certain cardiovascular drugs can induce hyperglycemia through multiple mechanisms, including altered the secretion and sensitivity of insulin through direct cytotoxic effects toward pancreatic beta cells and increased glucose secretion. Notably, diuretics, beta-blockers, calcium channel blockers, and statins have been associated with significant glycemic disturbances. The risk of hyperglycemia varies based on individual factors, drug dosages, and concurrent medications. These drug-induced hyperglycemic effects may sometimes reverse upon discontinuation of related medication. Effective management should include lifestyle modifications, the use of glucose-lowering medications, and opting for lower-risk cardiovascular drugs. Monitoring for hyperglycemia involves educating affected individuals and conducting regular blood glucose tests. Identifying at-risk individuals and implementing preventive measures are crucial for improving both cardiovascular and metabolic outcomes.
Conclusions
Certain cardiovascular drugs significantly contribute to hyperglycemia and diabetes mellitus through various mechanisms. Effective management includes identifying at-risk individuals, choosing lower-risk medications, and implementing monitoring and preventive strategies. Further research is needed to fully understand these mechanisms and develop targeted interventions to prevent and manage cardiovascular drug-induced hyperglycemia, thereby improving clinical outcomes.
{"title":"The impact of cardiovascular drugs on hyperglycemia and diabetes: a review of ‘unspoken' side effects","authors":"Wynne Widiarti , Pandit Bagus Tri Saputra , Cornelia Ghea Savitri , Johanes Nugroho Eko Putranto , Firas Farisi Alkaff","doi":"10.1016/j.hjc.2024.09.007","DOIUrl":"10.1016/j.hjc.2024.09.007","url":null,"abstract":"<div><h3>Aims</h3><div>The increasing prevalence of cardiovascular diseases has led to the widespread use of cardiovascular drugs that can adversely impact glucose metabolism. This review focuses on the latest evidence on the potential of cardiovascular drugs to induce adverse glycemic effects but also the underlying mechanisms, prevention, and management strategies.</div></div><div><h3>Materials and methods</h3><div>A comprehensive literature search was conducted across scientific databases until May 25th, 2024.</div></div><div><h3>Results</h3><div>Certain cardiovascular drugs can induce hyperglycemia through multiple mechanisms, including altered the secretion and sensitivity of insulin through direct cytotoxic effects toward pancreatic beta cells and increased glucose secretion. Notably, diuretics, beta-blockers, calcium channel blockers, and statins have been associated with significant glycemic disturbances. The risk of hyperglycemia varies based on individual factors, drug dosages, and concurrent medications. These drug-induced hyperglycemic effects may sometimes reverse upon discontinuation of related medication. Effective management should include lifestyle modifications, the use of glucose-lowering medications, and opting for lower-risk cardiovascular drugs. Monitoring for hyperglycemia involves educating affected individuals and conducting regular blood glucose tests. Identifying at-risk individuals and implementing preventive measures are crucial for improving both cardiovascular and metabolic outcomes.</div></div><div><h3>Conclusions</h3><div>Certain cardiovascular drugs significantly contribute to hyperglycemia and diabetes mellitus through various mechanisms. Effective management includes identifying at-risk individuals, choosing lower-risk medications, and implementing monitoring and preventive strategies. Further research is needed to fully understand these mechanisms and develop targeted interventions to prevent and manage cardiovascular drug-induced hyperglycemia, thereby improving clinical outcomes.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 71-77"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01DOI: 10.1016/j.hjc.2024.01.006
Ioannis Panayiotides MD , Joseph Westaby BMBS, PhD, FRCPath , Elijah R. Behr MA, MBBS, FRCP , Michael Papadakis MBBS, MRCP, MD, MRCP , Sanjay Sharma BSc, MBChB, FRCP, MD , Gherardo Finocchiaro MD, PhD , Mary N. Sheppard MBBCH, BAO, BSc, MD, FRCPath, FRCPI
Background
Sudden cardiac death (SCD) is relatively common and may occur in apparently healthy individuals. The role of seasonal variation as a risk factor for SCD is poorly understood. The aim of this study was to investigate whether SCD exhibits a predilection for specific seasons.
Methods
We reviewed a database of 4751 cases of SCD (mean age 38 ± 17 years) referred to our Center for Cardiac Pathology at St George’s University of London between 2000 and 2018. Clinical information was obtained from referring coroners who were asked to complete a detailed questionnaire. All cases underwent macroscopic and histological evaluation of the heart, by expert cardiac pathologists.
Results
SCD was more common during winter (26%) and rarer during summer (24%), p = 0.161. Significant seasonal variation was not observed among cases of sudden arrhythmic death syndrome (SADS, 2910 cases) in which the heart is structurally normal. In contrast, a significant difference in seasonal distribution among decedents exhibiting cardiac structural abnormalities at the post-mortem examination (n = 1841) was observed. In this subgroup, SCDs occurred more frequently during winter (27 %) compared to summer (22%) (p = 0.007). In cases diagnosed with a myocardial disease (n = 1399), SCD was most common during the winter (27%) and least common during the summer (22%) (p = 0.027).
Conclusions
While SADS occurs throughout the year with no seasonal variation, SCD due to structural heart disease appears to be more common during the winter. Bio-meteorological factors may be potential triggers of SCD in individuals with an underlying structural cardiac abnormality.
{"title":"Seasonal Variation in Sudden Cardiac Death: Insights from a Large United Kingdom Registry","authors":"Ioannis Panayiotides MD , Joseph Westaby BMBS, PhD, FRCPath , Elijah R. Behr MA, MBBS, FRCP , Michael Papadakis MBBS, MRCP, MD, MRCP , Sanjay Sharma BSc, MBChB, FRCP, MD , Gherardo Finocchiaro MD, PhD , Mary N. Sheppard MBBCH, BAO, BSc, MD, FRCPath, FRCPI","doi":"10.1016/j.hjc.2024.01.006","DOIUrl":"10.1016/j.hjc.2024.01.006","url":null,"abstract":"<div><h3>Background</h3><div>Sudden cardiac death (SCD) is relatively common and may occur in apparently healthy individuals. The role of seasonal variation as a risk factor for SCD is poorly understood. The aim of this study was to investigate whether SCD exhibits a predilection for specific seasons.</div></div><div><h3>Methods</h3><div>We reviewed a database of 4751 cases of SCD (mean age 38 ± 17 years) referred to our Center for Cardiac Pathology at St George’s University of London between 2000 and 2018. Clinical information was obtained from referring coroners who were asked to complete a detailed questionnaire. All cases underwent macroscopic and histological evaluation of the heart, by expert cardiac pathologists.</div></div><div><h3>Results</h3><div>SCD was more common during winter (26%) and rarer during summer (24%), p = 0.161. Significant seasonal variation was not observed among cases of sudden arrhythmic death syndrome (SADS, 2910 cases) in which the heart is structurally normal. In contrast, a significant difference in seasonal distribution among decedents exhibiting cardiac structural abnormalities at the post-mortem examination (n = 1841) was observed. In this subgroup, SCDs occurred more frequently during winter (27 %) compared to summer (22%) (p = 0.007). In cases diagnosed with a myocardial disease (n = 1399), SCD was most common during the winter (27%) and least common during the summer (22%) (p = 0.027).</div></div><div><h3>Conclusions</h3><div>While SADS occurs throughout the year with no seasonal variation, SCD due to structural heart disease appears to be more common during the winter. Bio-meteorological factors may be potential triggers of SCD in individuals with an underlying structural cardiac abnormality.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 3-9"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139495505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Twin circumflex arteries in a patient with lateral STEMI: Which is the culprit artery?","authors":"Nikitas Katsillis, Antonios Dimopoulos, Sarantos Linardakis, Nikolaos Papakonstantinou, Nikolaos Patsourakos","doi":"10.1016/j.hjc.2024.06.012","DOIUrl":"10.1016/j.hjc.2024.06.012","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 102-103"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sugars-related behavior of Greek University students and its association with different information sources","authors":"Georgios Marakis , Maria G. Grammatikopoulou , Michail Chourdakis , Lamprini Kontopoulou , Eleni Vasara , Aikaterini Orfanogiannaki , Gorgias Garofalakis , Spyridoula Mila , Zoe Mousia , Emmanuella Magriplis , Antonis Zampelas","doi":"10.1016/j.hjc.2024.07.009","DOIUrl":"10.1016/j.hjc.2024.07.009","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 88-91"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Endothelial dysfunction (ED), a well-established risk marker of cardiovascular events, is associated with heart failure (HF) and atrial fibrillation (AF). Its relationship with cardiovascular events in patients with HF undergoing AF ablation remains unclear. We aimed to elucidate the association between ED and the outcomes after AF ablation in patients with HF.
Methods
This prospective cohort study included patients with HF who underwent an endothelial function assessment using the peripheral vascular reactive hyperemia index (RHI) before first-time AF ablation. We defined AF recurrence according to the following types: the conventional form (AF≥30 seconds) and persistent form (requiring cardioversion). An RHI<2.1 indicated ED. Those with and without ED were compared in terms of the 3-year incidence of AF recurrence and cardiovascular events after AF ablation.
Results
Among 421 patients with HF (69 ± 9 years and 38% females), 343 (81.5%) had ED. Although the incidence of the conventional form of AF recurrence was similar between the groups, that of the persistent form was significantly higher in the ED group (25.7% vs. 15.3%, log-rank P = 0.028). The ED group also had a significantly higher rate of cardiovascular events (14.8% vs. 3.6%, log-rank P = 0.028). Pre-procedural ED was identified as an independent predictor of a persistent form of AF recurrence (adjusted hazard ratio [HR] 2.31, 95% confidence interval [CI] 1.05–5.07, P = 0.037) and that of cardiovascular events (adjusted HR 4.21, 95% CI 1.02–17.5, P = 0.048), respectively.
Conclusions
The endothelial function assessment enabled the risk stratification of clinically problematic outcomes after AF ablation in patients with HF.
背景:内皮功能障碍(ED)是心血管事件的公认风险指标,与心力衰竭(HF)和心房颤动(AF)有关。在接受房颤消融术的高血压患者中,ED与心血管事件的关系仍不明确。我们旨在阐明 ED 与接受房颤消融术的高血压患者房颤消融术后的结果之间的关系:这项前瞻性队列研究纳入了在首次房颤消融术前使用外周血管反应性充血指数(RHI)进行内皮功能评估的房颤患者。我们根据以下类型定义房颤复发:常规形式(房颤≥30 秒)和持续形式(需要心脏复律)。结果:在 421 名房颤患者(69±9 岁,女性占 38%)中,343 人(81.5%)患有房颤。虽然两组常规房颤复发率相似,但 ED 组的持续性房颤复发率明显更高(25.7% 对 15.3%,对数秩 P=0.028)。ED 组的心血管事件发生率也明显更高(14.8% 对 3.6%,对数秩 P=0.028)。术前ED被确定为房颤持续复发(调整后危险比[HR]2.31,95%置信区间[CI]1.06-5.06,P=0.035)和心血管事件(调整后危险比4.26,95%置信区间[CI]1.03-17.7,P=0.028)的独立预测因素:内皮功能评估有助于对心房颤动患者房颤消融术后的临床问题结果进行风险分层。
{"title":"Pre-procedural Stratification by the Endothelial Function in Patients with Heart Failure Undergoing Atrial Fibrillation Ablation","authors":"Akihiro Oka MD , Yuya Sudo MD , Takeshi Morimoto MD, PhD, MPH , Ryu Tsushima MD , Masahiro Sogo MD , Masatomo Ozaki MD , Masahiko Takahashi MD , Keisuke Okawa MD, PhD","doi":"10.1016/j.hjc.2024.02.003","DOIUrl":"10.1016/j.hjc.2024.02.003","url":null,"abstract":"<div><h3>Background</h3><div>Endothelial dysfunction (ED), a well-established risk marker of cardiovascular events, is associated with heart failure (HF) and atrial fibrillation (AF). Its relationship with cardiovascular events in patients with HF undergoing AF ablation remains unclear. We aimed to elucidate the association between ED and the outcomes after AF ablation in patients with HF.</div></div><div><h3>Methods</h3><div>This prospective cohort study included patients with HF who underwent an endothelial function assessment using the peripheral vascular reactive hyperemia index (RHI) before first-time AF ablation. We defined AF recurrence according to the following types: the conventional form (AF≥30 seconds) and persistent form (requiring cardioversion). An RHI<2.1 indicated ED. Those with and without ED were compared in terms of the 3-year incidence of AF recurrence and cardiovascular events after AF ablation.</div></div><div><h3>Results</h3><div>Among 421 patients with HF (69 ± 9 years and 38% females), 343 (81.5%) had ED. Although the incidence of the conventional form of AF recurrence was similar between the groups, that of the persistent form was significantly higher in the ED group (25.7% vs. 15.3%, log-rank P = 0.028). The ED group also had a significantly higher rate of cardiovascular events (14.8% vs. 3.6%, log-rank P = 0.028). Pre-procedural ED was identified as an independent predictor of a persistent form of AF recurrence (adjusted hazard ratio [HR] 2.31, 95% confidence interval [CI] 1.05–5.07, P = 0.037) and that of cardiovascular events (adjusted HR 4.21, 95% CI 1.02–17.5, P = 0.048), respectively.</div></div><div><h3>Conclusions</h3><div>The endothelial function assessment enabled the risk stratification of clinically problematic outcomes after AF ablation in patients with HF.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 51-59"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139718086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giant cell arteritis (GCA) is a chronic inflammatory condition associated with a significantly increased risk of various cardiovascular and thromboembolic events. Existing studies suggest an increased risk of cardiovascular disease in GCA, but results vary. This meta-analysis aims to quantify the association between GCA and the risk of various cardiovascular outcomes, providing a comprehensive evaluation of the cardiovascular burden in patients with GCA.
Methods
A comprehensive literature search was carried out using several databases. Studies were included based on predefined eligibility criteria. Using random effect models, Mantel-Haenszel odds ratios and associated 95% confidence intervals were produced to report the overall effect size. Funnel plots, Egger regression tests, and Begg-Mazumdar's rank correlation test were used to assess publication bias. The endpoint included any cardiovascular events, myocardial infarction (MI), coronary artery disease (CAD), aortic aneurysm/dissection, peripheral artery disease (PAD), stroke, and venous thromboembolism.
Results
The meta-analysis included 14 studies with a combined sample size of 609,954 patients, where the mean age was 73.8 years and 72.2% were female. Patients with GCA had significantly higher odds of experiencing any cardiovascular event (OR = 1.81, 95% CI = 1.55–2.15), acute myocardial infarction (OR = 1.63, 95% CI = 1.34–1.97), coronary artery disease (OR = 1.51, 95% CI = 1.09–2.08), aortic aneurysm/dissection (OR = 1.95, 95% CI = 1.55–2.46), peripheral artery disease (OR = 2.02, 95% CI = 1.69–2.41), stroke (OR = 1.52, 95% CI = 1.25–1.84), venous thromboembolism (OR = 1.92, 95% CI = 1.73–2.12), deep vein thrombosis (OR = 2.09, 95% CI = 1.50–2.91) and pulmonary embolism (OR = 2.45, 95% CI = 1.38–4.36). The heterogeneity of the outcomes ranged from low to high across different analyses. No publication bias was evident in the analysis.
Conclusion
The meta-analysis highlights the critical need for vigilant cardiovascular monitoring and proactive management strategies in GCA patients. Further research is needed to identify specific factors that contribute to cardiovascular complications in these patients.
背景:巨细胞动脉炎(GCA)是一种慢性炎症,与各种心血管和血栓栓塞事件的风险显著增加有关。现有研究表明,GCA 患者罹患心血管疾病的风险增加,但结果各不相同。本荟萃分析旨在量化 GCA 与各种心血管疾病风险之间的关联,从而全面评估 GCA 患者的心血管负担:方法:使用多个数据库进行了全面的文献检索。方法:利用多个数据库进行了全面的文献检索,并根据预先确定的资格标准纳入了相关研究。使用随机效应模型、Mantel-Haenszel 赔率和相关的 95% 置信区间来报告总体效应大小。漏斗图、Egger回归检验和Begg-Mazumdar秩相关检验用于评估发表偏倚。终点包括任何心血管事件、心肌梗死(MI)、冠状动脉疾病(CAD)、主动脉瘤/夹层、外周动脉疾病(PAD)、中风和静脉血栓栓塞:荟萃分析包括 14 项研究,样本量共计 609,954 例患者,平均年龄为 73.8 岁,72.2% 为女性。GCA 患者发生任何心血管事件(OR = 1.81,95% CI = 1.55 至 2.15)、急性心肌梗死(OR = 1.63,95% CI = 1.34 至 1.97)、冠状动脉疾病(OR = 1.51,95% CI = 1.09 至 2.08)、主动脉瘤/夹层(OR = 1.95,95% CI = 1.55 to 2.46)、外周动脉疾病(OR = 2.02,95% CI = 1.69 to 2.41)、中风(OR = 1.52,95% CI = 1.25 to 1.84)、静脉血栓栓塞(OR = 1.92,95% CI = 1.73 to 2.12)、深静脉血栓(OR = 2.09,95% CI = 1.50 to 2.91)和肺栓塞(OR = 2.45,95% CI = 1.38 to 4.36)。不同分析结果的异质性从低到高不等。分析中未发现明显的发表偏倚:荟萃分析强调了对 GCA 患者进行警惕性心血管监测和采取积极管理策略的迫切需要。还需要进一步研究,以确定导致这些患者出现心血管并发症的具体因素。
{"title":"Risk of cardiovascular events in giant cell arteritis: systematic review and meta-analysis","authors":"Sawai Singh Rathore , Prakhyath Srikaram , Samyukta Gudena , Swetha Manoj , Sanjana Reddy Allam , Mohammad Abdalla Hatamleh , Naga Siva Naveen Chodisetti , Shifa Parvez Shaikh , Chiranjeevee Ramanathan Saravanan , Nathnael Abera Woldehana , Bijay Mukesh Jeswani","doi":"10.1016/j.hjc.2024.10.008","DOIUrl":"10.1016/j.hjc.2024.10.008","url":null,"abstract":"<div><h3>Objective</h3><div>Giant cell arteritis (GCA) is a chronic inflammatory condition associated with a significantly increased risk of various cardiovascular and thromboembolic events. Existing studies suggest an increased risk of cardiovascular disease in GCA, but results vary. This meta-analysis aims to quantify the association between GCA and the risk of various cardiovascular outcomes, providing a comprehensive evaluation of the cardiovascular burden in patients with GCA.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was carried out using several databases. Studies were included based on predefined eligibility criteria. Using random effect models, Mantel-Haenszel odds ratios and associated 95% confidence intervals were produced to report the overall effect size. Funnel plots, Egger regression tests, and Begg-Mazumdar's rank correlation test were used to assess publication bias. The endpoint included any cardiovascular events, myocardial infarction (MI), coronary artery disease (CAD), aortic aneurysm/dissection, peripheral artery disease (PAD), stroke, and venous thromboembolism.</div></div><div><h3>Results</h3><div>The meta-analysis included 14 studies with a combined sample size of 609,954 patients, where the mean age was 73.8 years and 72.2% were female. Patients with GCA had significantly higher odds of experiencing any cardiovascular event (OR = 1.81, 95% CI = 1.55–2.15), acute myocardial infarction (OR = 1.63, 95% CI = 1.34–1.97), coronary artery disease (OR = 1.51, 95% CI = 1.09–2.08), aortic aneurysm/dissection (OR = 1.95, 95% CI = 1.55–2.46), peripheral artery disease (OR = 2.02, 95% CI = 1.69–2.41), stroke (OR = 1.52, 95% CI = 1.25–1.84), venous thromboembolism (OR = 1.92, 95% CI = 1.73–2.12), deep vein thrombosis (OR = 2.09, 95% CI = 1.50–2.91) and pulmonary embolism (OR = 2.45, 95% CI = 1.38–4.36). The heterogeneity of the outcomes ranged from low to high across different analyses. No publication bias was evident in the analysis.</div></div><div><h3>Conclusion</h3><div>The meta-analysis highlights the critical need for vigilant cardiovascular monitoring and proactive management strategies in GCA patients. Further research is needed to identify specific factors that contribute to cardiovascular complications in these patients.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 78-87"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}