Acta cardiologica最新文献

Background: Platelet transfusion rate is associated with mortality in patients with AD. However, the relationship between platelet transfusion rate thresholds and the risk of death in patients with AD remains to be determined.

Methods: We reviewed a total of 443 patients with AD. Patients were divided into two groups [≤144.75 mL/h (N = 178) and >144.75 mL/h (N = 265)] on the basis of platelet transfusion rate thresholds analysed via characteristic curves. The correlation between platelet count and long-term mortality was assessed via Cox survival analysis. In addition, we used a generalised additive model (GAM) with a restricted cubic spline (RCS) to explore the nonlinear relationship between platelet transfusion rate and outcome.

Results: Subjects with high platelet transfusion rate had significantly lower in-hospital mortality. Univariate Cox analysis revealed that a platelet transfusion rate greater than 144.75 mL/h was a significant factor for reducing death (corrected HR = 0.38, 95% CI, 0.22-0.64; p < 0.01). Multivariate Cox analysis demonstrated that platelet transfusion rate of >144.75 mL/h was a significant factor in reducing death (corrected HR = 0.34, 95% CI, 0.18-0.64; p < 0.01). Kaplan-Meier curve analysis further demonstrated that platelet transfusion rate of >144.75 mL/h was a significant factor in reducing death (p < 0.01).

Conclusion: A platelet transfusion rate of 144.75 mL/h was the inflection point for the risk of death in patients with AD, whereas a platelet transfusion rate of 282.5 mL/h was the nadir for the risk of in-hospital death.

Background: Transcatheter aortic valve replacement (TAVR) has transformed the treatment of severe aortic stenosis in patients at high or prohibitive surgical risk. Despite high procedural success, postoperative complications remain common and clinically consequential. Understanding how research on these complications has evolved is essential for guiding future investigations and improving outcomes. This study maps the global research landscape of TAVR-associated postoperative complications, with emphasis on thematic evolution, collaboration patterns, and emerging mechanistic and analytical approaches.

Methods: A bibliometric analysis of publications from 2006 to 2025 was conducted using the Web of Science Core Collection. Publication trends, contributing countries and institutions, authors, subject categories, and journals were analysed. CiteSpace and VOSviewer were used to visualise keyword co-occurrence, citation bursts, collaboration networks, and thematic clusters.

Results: A total of 3587 publications were identified, with rapid growth after 2014. The United States led in publication output and international collaboration, followed by Germany, Italy, and the United Kingdom. Research themes shifted from early feasibility studies towards complication-focused topics. High-frequency keywords included stroke, paravalvular leak, and bundle branch block, while recent attention has increasingly focused on frailty, sarcopenia, and multimorbidity. Biomechanical terms such as finite element and fluid-structure interaction reflected deeper mechanistic exploration. The literature spanned over 20 disciplines, indicating strong interdisciplinarity.

Conclusions: The field has shifted from procedural feasibility to multidisciplinary, mechanism-oriented studies of complications affecting long-term outcomes, with frailty emerging as a key patient-centred determinant in older TAVR populations.

Background: Beta thalassaemia, an inherited blood disorder, exhibits a broad range of phenotypes from asymptomatic to severe anaemia. Pulmonary hypertension (PH) is a major complication in thalassaemia patients, significantly impacting morbidity and mortality. This study aimed to assess the clinical condition of thalassaemia patients with PH over the course of one year while receiving treatment in accordance with the guidelines of the European Society of Cardiology (ESC).

Methods: A prospective cohort study was carried out at Rohani Hospital in Iran from May 2020 to May 2021. The study included patients diagnosed with beta thalassaemia intermedia who also had PH confirmed by echocardiography. Treatment was administered according to ESC guidelines, incorporating vasodilators and other supportive medications. Clinical and laboratory data were gathered, and statistical analyses were conducted.

Results: Nineteen patients, with a mean age of 42.57 ± 8.62 years, participated in the study. Treatment resulted in notable improvements in the 6-minute walk test (6MWT) (p < 0.001), reduced proBNP levels (p = 0.016), and a lower E/e' ratio (p = 0.01), suggesting enhanced right ventricular (RV) function. However, there were no significant changes in pulmonary artery pressure (PAP) or RV size. Additionally, repeated blood transfusions were linked to RV dysfunction.

Conclusions: Repeated blood transfusions correlate with RV dysfunction in thalassaemia patients with PH. Vasodilatory treatment improves 6MWT, proBNP levels, and E/e' ratio, indicating RV function enhancement. This study underscores the importance of comprehensive management strategies for thalassaemia patients with PH to mitigate associated complications and improve outcomes.

Ku et al. recently reported clinical predictors of failed electrical cardioversion (ECV) in patients with persistent or long-standing persistent atrial fibrillation. While the multicentre cohort and comprehensive echocardiographic assessment provide valuable data, several methodological and interpretative issues merit further discussion. These include the retrospective design and potential residual confounding, heterogeneity in ECV protocols across centres, reliance on intermittent rhythm monitoring for outcome assessment, and limited integration of contemporary atrial cardiomyopathy concepts into risk stratification. Moreover, the clinical implications of preferring rate control in high-risk subgroups require cautious interpretation in light of modern rhythm-control evidence. Addressing these aspects may enhance the translational impact of the findings and refine patient selection for rhythm-control strategies.

Background: Surrogacy utilises assisted reproductive technology including artificial intrauterine insemination, in-vitro fertilization (IVF), and frozen embryo transfer to help achieve parenthood. The differences in adverse cardiovascular outcomes of surrogate pregnancy compared to traditional pregnancy are not well studied.

Methods: Pregnant patients were procured from the National Inpatient Sample database. Patients were stratified into surrogate and non-surrogate pregnancy groups. The primary outcome was major adverse cardiovascular event (MACE), conduction abnormalities, pre-eclampsia, gestational diabetes (GDM), and mortality. Secondary outcomes included individual components of MACE, individual components of conduction abnormalities, spontaneous coronary artery dissection, aortic dissection, Takotsubo cardiomyopathy, and length of hospital stay.

Results: Of 1,942,429 pregnant patients, 3,922 were surrogate patients. Surrogate patients tended to be older and have higher Caucasian prevalence. MACE rates were similar between both groups. Surrogate carriers had increased conduction abnormalities, bundle branch blocks, supraventricular tachycardia, ventricular tachycardia, pre-eclampsia, GDM, and an increased length of hospital stay relative to non-surrogate patients. After multivariate analysis, surrogate carriers had elevated risk for conduction abnormalities, pre-eclampsia, and gestational diabetes. No differences in outcomes were found when comparing traditional surrogacy vs gestational surrogacy.

Conclusion: Surrogate carriers were more likely to have conduction abnormalities, pre-eclampsia, and GDM, and increased length of hospital stay with similar rates of MACE when compared to non-surrogate carriers. Surrogate pregnancy appears to be a safe and appealing option for women struggling with fertility, however, consideration should be given to the incorporation of dedicated cardiovascular care into the routine follow-up of these patients.