American heart journal plus : cardiology research and practice最新文献_第10页

Cardiomyopathy in valosin-containing protein multisystem proteinopathy: Evaluation, diagnosis, and management 含缬缬素蛋白多系统蛋白病的心肌病：评估、诊断和管理

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-10-15 DOI: 10.1016/j.ahjo.2025.100644

Joshua M. Chan , Candela Romano , Andy Y. Lee , Stephani Wang , Dawn Lombardo , Forum Kamdar , Michaela Dora , Shaida Khan , Pradeep Mammen , Virginia Kimonis

Valosin-containing protein (VCP)-associated multisystem proteinopathy is a rare, autosomal dominant disease that affects skeletal muscle, bone, central nervous system, and the heart. While VCP mutations are well established as causing inclusion body myopathy, Paget's disease of bone, frontotemporal dementia, and amyotrophic lateral sclerosis, their role in cardiomyopathy remains underrecognized. This review aims to evaluate the pathophysiology, diagnostic approach, and management of VCP-associated cardiomyopathy to provide a framework for clinical care and future research.

Emerging evidence from animal models and human case studies suggests that VCP dysfunction disrupts cardiomyocyte homeostasis, impairs protein degradation, and alters mitochondrial function, leading to maladaptive cardiac remodeling and susceptibility to dilated or hypertrophic cardiomyopathy. Echocardiographic studies in patients with VCP variants reveal a significant prevalence of diastolic dysfunction, conduction abnormalities, and variable degrees of systolic impairment. Despite these findings, there are no standardized guidelines for the diagnosis and management of VCP-associated cardiomyopathy. Current treatment strategies are extrapolated from heart failure guidelines, incorporating neurohormonal blockades with angiotensin-converting enzyme inhibitors, beta-blockers, and mineralocorticoid receptor antagonists.

Our review highlights the need for systematic screening protocols, genotype-phenotype correlation studies, and the development of targeted therapies. Future research should focus on identifying biomarkers for early detection, elucidating the molecular mechanisms underlying cardiac dysfunction, and assessing the efficacy of novel treatment strategies. Recognizing VCP-associated cardiomyopathy as a distinct clinical entity will facilitate earlier diagnosis, improve patient outcomes, pave the way for disease-specific therapeutic interventions and insights into the mechanism for isolated cardiomyopathy.

含缬氨酸蛋白（VCP）相关的多系统蛋白病是一种罕见的常染色体显性遗传病，可影响骨骼肌、骨骼、中枢神经系统和心脏。虽然VCP突变可以引起包涵体肌病、骨佩吉特病、额颞叶痴呆和肌萎缩侧索硬化症，但它们在心肌病中的作用仍未得到充分认识。本综述旨在评价vcp相关心肌病的病理生理学、诊断方法和治疗，为临床护理和未来的研究提供框架。来自动物模型和人类病例研究的新证据表明，VCP功能障碍破坏心肌细胞稳态，损害蛋白质降解，改变线粒体功能，导致心脏重构不适应和扩张性或肥厚性心肌病的易感性。超声心动图研究显示，VCP变异患者存在明显的舒张功能障碍、传导异常和不同程度的收缩功能损害。尽管有这些发现，对于vcp相关心肌病的诊断和治疗还没有标准化的指南。目前的治疗策略是从心力衰竭指南中推断出来的，包括神经激素阻断剂、血管紧张素转换酶抑制剂、受体阻滞剂和矿皮质激素受体拮抗剂。我们的综述强调了系统筛选方案、基因型-表型相关性研究和靶向治疗开发的必要性。未来的研究应侧重于识别早期检测的生物标志物，阐明心功能障碍的分子机制，并评估新的治疗策略的疗效。认识到vcp相关心肌病是一种独特的临床实体，将有助于早期诊断，改善患者预后，为疾病特异性治疗干预铺平道路，并深入了解孤立性心肌病的机制。

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引用次数: 0

Post-thoracic aortic aneurysm procedural mental wellbeing: A scoping review 胸主动脉瘤后手术心理健康：范围回顾

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-10-15 DOI: 10.1016/j.ahjo.2025.100642

Jasper C. Murphy , Natalie K. Kolba , Ian T. Winkeler , Lichun He , Deborah M. Li , Claire D. Kim , Jonathan D. Price , Thomas V. Bilfinger , Henry J. Tannous , Allison J. McLarty , A. Laurie Shroyer

引用次数: 0

Letter by Zhang regarding article, “supersaturated oxygen therapy using radial artery access to prevent left ventricular remodeling after anterior ST-segment elevation myocardial infarction: A randomized, controlled trial” Zhang关于文章“桡动脉过饱和氧治疗预防st段抬高型心肌梗死后左室重构：一项随机对照试验”的来信。

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-10-14 DOI: 10.1016/j.ahjo.2025.100641

Zonglei Zhang

引用次数: 0

Circulating mitochondrial cell-free DNA levels are associated with the recurrence of atrial fibrillation after catheter ablation for atrial fibrillation 房颤导管消融后循环线粒体游离DNA水平与房颤复发相关

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-10-14 DOI: 10.1016/j.ahjo.2025.100638

Tomoko Takahashi , Takeshi Soeki , Kazuki Tezuka , Tomomi Matsuura , Etsuko Uematsu , Hiroyuki Aibara , Ryou Bando , Robert Zheng , Tomonori Takahashi , Yoshihito Saijo , Yutaka Kawabata , Muneyuki Kadota , Tomoya Hara , Rie Ueno , Takayuki Ise , Koji Yamaguchi , Shusuke Yagi , Hirotsugu Yamada , Daiju Fukuda , Masataka Sata

Background

Although catheter ablation, including pulmonary vein isolation, is the primary nonpharmacological therapy for atrial fibrillation (AF), atrial arrhythmia often recurs. Recent studies have linked circulating mitochondrial cell-free DNA (mt-cfDNA), a potential contributor to inflammatory disorders, with AF. In this study, we evaluated the relationship between plasma mt-cfDNA levels and AF recurrence after catheter ablation in patients with AF.

Methods

Peripheral blood was obtained from 58 patients with AF (34 paroxysmal and 24 persistent AF) who underwent catheter ablation and from the control group (10 patients without AF). We extracted total cfDNA and mt-cfDNA from the patients.

Results

The total cfDNA concentration and copy number of mt-cfDNA were significantly higher in patients with AF than in controls. During the 16-month follow-up after catheter ablation, AF recurred in 11 patients (19.0 %). In patients with AF, the copy number of mt-cfDNA before catheter ablation was higher in the recurrent group than in the non-recurrent group. However, total cfDNA concentrations did not differ significantly between patients with and without AF recurrence. The left atrial volume index (LAVI) was higher in patients with recurrent AF than in those without. Cox proportional hazards regression analysis showed that the mt-cfDNA copy number was significantly associated with AF recurrence after catheter ablation, independent of age, sex, body mass index, LAVI, and AF type.

Conclusion

Elevated mt-cfDNA levels may be a sensitive predictor of AF recurrence after catheter ablation in patients with AF.

背景：虽然导管消融（包括肺静脉隔离）是心房颤动（AF）的主要非药物治疗方法，但心房心律失常经常复发。最近的研究将循环线粒体无细胞DNA （mt-cfDNA）与房颤联系起来，这是炎症性疾病的潜在因素。在这项研究中，我们评估了房颤患者导管消融后血浆mt-cfDNA水平与房颤复发之间的关系。方法采集了58例房颤患者（34例阵发性房颤，24例持续性房颤）和对照组（10例非房颤）的外周血。我们从患者身上提取总cfDNA和mt-cfDNA。结果AF患者cfDNA总浓度和mt-cfDNA拷贝数明显高于对照组。在导管消融后16个月的随访中，11例患者（19.0%）房颤复发。在房颤患者中，复发组在导管消融前的mt-cfDNA拷贝数高于非复发组。然而，总cfDNA浓度在有和没有房颤复发的患者之间没有显著差异。复发性房颤患者左房容积指数（LAVI）高于非复发性房颤患者。Cox比例风险回归分析显示，mt-cfDNA拷贝数与房颤消融后复发显著相关，与年龄、性别、体重指数、LAVI、房颤类型无关。结论mt-cfDNA水平升高可能是房颤患者导管消融后房颤复发的敏感预测因子。

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引用次数: 0

Association of physical activity and sedentary behavior with stages of cardiovascular–kidney–metabolic syndrome among U.S. adults: NHANES 2007–2020 美国成年人身体活动和久坐行为与心血管-肾脏-代谢综合征阶段的关联：NHANES 2007-2020

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-10-14 DOI: 10.1016/j.ahjo.2025.100639

Shuo Pang , Yuxi Dongye , Yingwei Bi , Jianbo Wang

Background

Cardiovascular–kidney–metabolic (CKM) syndrome, newly defined by the American Heart Association, integrates metabolic risk factors, chronic kidney disease, and cardiovascular dysfunction. Although clinically important, evidence-based prevention strategies remain limited. This study examined associations of moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) with CKM stage in a representative U.S. adult sample.

Methods

We used survey-weighted multinomial logistic regression and restricted cubic splines (RCS). MVPA was classified as 0, 1–149, and ≥ 150 min/week; SB as <5, 5–8, and ≥ 8 h/day; CKM was staged 0–4 (stage 0 as reference). Predefined subgroups were age (20–59 vs 60–79 years), sex (female vs male) and PIR (high >3.49; medium >1.49–<3.49; low ≤1.49).

Results

Compared with individuals reporting no MVPA, those achieving ≥150 min/week had approximately 33 % lower odds of CKM stage 1 (OR 0.67, 95 % CI 0.46–0.97), 44 % lower odds of stage 2 (OR 0.56, 95 % CI 0.38–0.83), 92 % lower odds of stage 3 (OR 0.09, 95 % CI 0.02–0.32), and 65 % lower odds of stage 4 (OR 0.35, 95 % CI 0.19–0.63). Subgroup analyses by age, sex, poverty–income ratio, and SB indicated that the protective impact of MVPA was evident across age and socioeconomic subgroups, with relatively stronger associations among younger adults and benefits at both low and high socioeconomic strata. By contrast, SB showed weaker independent associations with CKM severity after full adjustment.

Conclusions

Greater MVPA was associated with lower odds of advanced CKM stage. These findings highlight the role of physical activity in CKM prevention and support public health strategies to reduce lifestyle-related risks.

背景：心血管-肾代谢综合征（CKM）是美国心脏协会新近定义的一种综合了代谢危险因素、慢性肾脏疾病和心血管功能障碍的综合征。尽管在临床上很重要，但基于证据的预防策略仍然有限。本研究在具有代表性的美国成人样本中检测了中高强度体力活动（MVPA）和久坐行为（SB）与CKM分期的关系。方法采用调查加权多项式逻辑回归和限制性三次样条（RCS）方法。MVPA分为0、1 ~ 149和≥150 min/周；SB = 5、5 - 8、≥8 h/天；CKM分为0 - 4阶段（参照0阶段）。预定义亚组为年龄（20-59岁vs 60-79岁）、性别（女性vs男性）和PIR（高>；3.49；中>；1.49 -<3.49；低≤1.49）。结果与没有MVPA的个体相比，≥150分钟/周的患者CKM 1期的发生率降低约33% (OR 0.67, 95% CI 0.46-0.97)， 2期的发生率降低44% (OR 0.56, 95% CI 0.38-0.83)， 3期的发生率降低92% (OR 0.09, 95% CI 0.02-0.32)， 4期的发生率降低65% （OR 0.35, 95% CI 0.19-0.63）。按年龄、性别、贫困收入比和生理年龄进行的亚组分析表明，MVPA的保护作用在年龄和社会经济亚组中都很明显，在年轻人中相对较强，在低社会经济阶层和高社会经济阶层中都有益处。相比之下，完全调整后SB与CKM严重程度的独立相关性较弱。结论MVPA越大，CKM晚期的发生几率越低。这些发现强调了体育活动在CKM预防中的作用，并支持公共卫生策略以减少与生活方式相关的风险。

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引用次数: 0

Regional differences in characteristics of patients with acute coronary syndromes pre- and during Coronavirus-2019 pandemic 2019冠状病毒大流行前后急性冠状动脉综合征患者特征的地区差异

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-10-14 DOI: 10.1016/j.ahjo.2025.100640

K. Bryniarski , D. Makowicz , P. Kleczynski , M. Nosal , P. Brzychczy , K. Mroz , M. Okarski , J. Twardosz , M. Gasior , J. Legutko

Introduction

Coronavirus-2019 (COVID-19) pandemic placed unprecedented levels of stress on healthcare systems leading to prolonged waiting times and reduced access to emergency medical services. With acute coronary syndrome (ACS) longer delays could mean worsening of the symptoms of admitted patients. Studies exploring ACS in COVID-19 reported either results from one hospital or nation-wide registries and many of them did not report laboratory values. Aim of our study was to compare differences in patients and procedural characteristics before and during COVID-19 period in two hospitals differing mainly in population characteristics.

Methods

Data was gathered in two polish cities – Krakow (2nd biggest city in Poland) and Krosno (smaller city with big rural areas). We have analyzed years 2019 and 2020 and included 448 patients in Krosno and 678 patients in Krakow.

Results

In Krosno during pandemic patients were significantly more often transported from home by emergency medical services as opposed to period before COVID-19 (16.3 % vs. 62.2 %). Killip class at admission in Krosno was higher during pandemic (3.5 % vs. 10.4 % for Killip class 4). Similarly, patients in Krosno in 2020 had significantly higher troponin and NT-proBNP levels. We did not observe any of those differences in Krakow. Procedural characteristics were comparable in both interventional cardiology centers.

Conclusions

Even among the same country large differences in health condition of patients with ACS may be observed between different areas. Those results highlight the need of regional protocols on how to improve patient related factors and accessibility to healthcare system during unprecedented events.

2019冠状病毒（COVID-19）大流行给医疗保健系统带来了前所未有的压力，导致等待时间延长，获得紧急医疗服务的机会减少。对于急性冠脉综合征（ACS），较长的延迟可能意味着入院患者的症状恶化。探索COVID-19中ACS的研究报告的结果要么来自一家医院，要么来自全国范围的登记处，其中许多没有报告实验室值。本研究的目的是比较两家主要人群特征不同的医院在COVID-19之前和期间的患者和程序特征的差异。方法数据收集于波兰两个城市——克拉科夫（波兰第二大城市）和克罗斯诺（农村面积较大的小城市）。我们分析了2019年和2020年，包括克罗斯诺的448名患者和克拉科夫的678名患者。结果大流行期间，克罗斯诺患者通过紧急医疗服务从家中转移的频率明显高于疫情前（16.3% vs. 62.2%）。大流行期间，Krosno的Killip级入学率较高（3.5% vs. Killip 4级10.4%）。同样，2020年克罗斯诺患者的肌钙蛋白和NT-proBNP水平也明显升高。我们在克拉科夫没有观察到任何这些差异。两个介入性心脏病中心的手术特点具有可比性。结论同一国家不同地区ACS患者健康状况存在较大差异。这些结果突出了如何在前所未有的事件中改善患者相关因素和卫生保健系统可及性的区域协议的必要性。

{"title":"Regional differences in characteristics of patients with acute coronary syndromes pre- and during Coronavirus-2019 pandemic","authors":"K. Bryniarski , D. Makowicz , P. Kleczynski , M. Nosal , P. Brzychczy , K. Mroz , M. Okarski , J. Twardosz , M. Gasior , J. Legutko","doi":"10.1016/j.ahjo.2025.100640","DOIUrl":"10.1016/j.ahjo.2025.100640","url":null,"abstract":"<div><h3>Introduction</h3><div>Coronavirus-2019 (COVID-19) pandemic placed unprecedented levels of stress on healthcare systems leading to prolonged waiting times and reduced access to emergency medical services. With acute coronary syndrome (ACS) longer delays could mean worsening of the symptoms of admitted patients. Studies exploring ACS in COVID-19 reported either results from one hospital or nation-wide registries and many of them did not report laboratory values. Aim of our study was to compare differences in patients and procedural characteristics before and during COVID-19 period in two hospitals differing mainly in population characteristics.</div></div><div><h3>Methods</h3><div>Data was gathered in two polish cities – Krakow (2nd biggest city in Poland) and Krosno (smaller city with big rural areas). We have analyzed years 2019 and 2020 and included 448 patients in Krosno and 678 patients in Krakow.</div></div><div><h3>Results</h3><div>In Krosno during pandemic patients were significantly more often transported from home by emergency medical services as opposed to period before COVID-19 (16.3 % vs. 62.2 %). Killip class at admission in Krosno was higher during pandemic (3.5 % vs. 10.4 % for Killip class 4). Similarly, patients in Krosno in 2020 had significantly higher troponin and NT-proBNP levels. We did not observe any of those differences in Krakow. Procedural characteristics were comparable in both interventional cardiology centers.</div></div><div><h3>Conclusions</h3><div>Even among the same country large differences in health condition of patients with ACS may be observed between different areas. Those results highlight the need of regional protocols on how to improve patient related factors and accessibility to healthcare system during unprecedented events.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"60 ","pages":"Article 100640"},"PeriodicalIF":1.8,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reduced native T1 on cardiac magnetic resonance imaging as a novel marker of myocardial involvement in Niemann-Pick disease type B 心脏磁共振成像上原生T1降低作为B型尼曼-匹克病心肌受累的新标志物

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-10-10 DOI: 10.1016/j.ahjo.2025.100636

Betim Redzepi , Panagiotis Antiochos , Christel Tran , Joana Vieira Barbosa , Ambra Masi , Meng Zhang , Revi Adheriyani , Belinda Campos-Xavier , Juerg Schwitter

Background

Niemann-Pick disease type B (NPD-B) is a rare lysosomal storage disorder caused by biallelic mutations in the SMPD1 gene, leading to deficient acid sphingomyelinase activity and lipid accumulation in various organs. Although cardiac involvement is known in similar disorders like Anderson-Fabry disease, the myocardial impact in NPD-B remains poorly characterized.

Methods

Two adult patients with genetically confirmed NPD-B underwent multiparametric cardiac magnetic resonance (CMR) including native T1 mapping and late gadolinium enhancement (LGE). Clinical, biochemical, and histopathological data were reviewed.

Results

Patient 1, a 59-year-old man with a homozygous SMPD1 mutation (c.[Arg610del]), showed advanced pulmonary disease and liver steatosis. CMR revealed biventricular dilation with preserved systolic function and reduced native T1 values without LGE, suggesting myocardial lipid accumulation. Despite enzyme replacement therapy, the patient died of pulmonary complications 22 months later.

Patient 2, a 31-year-old woman with compound heterozygous SMPD1 mutations (c.[739G > A], c.[1801G > A]), had cirrhosis, dyslipidemia, and stable lung disease. CMR showed normal T1 values and no cardiac abnormalities.

Discussion/conclusions

This study compares two adult NPD-B patients who underwent CMR imaging. The first patient who died during follow-up showed reduced native T1 values, suggesting myocardial lipid accumulation, while the second had normal values and no complications during follow-up. These two patients are reported here to stimulate research in this field, as native T1 may aid in assessment of myocardial involvement. The two cases also suggest a potential influence of genetic mutations on disease severity. Given the risk of cardiac involvement in NPD-B, CMR — especially T1 mapping — may be a valuable tool for assessing myocardial infiltration. Future studies are needed to explore its correlation with genotype, disease progression, and treatment response.

niemann - pick病B型（NPD-B）是一种罕见的溶酶体贮积性疾病，由SMPD1基因双等位基因突变引起，导致酸性鞘磷脂酶活性不足和各器官脂质积累。虽然在安德森-法布里病等类似疾病中已知心脏受累，但NPD-B对心肌的影响仍不清楚。方法2例遗传确诊的成年NPD-B患者行多参数心脏磁共振（CMR）检查，包括原生T1定位和晚期钆增强（LGE）。回顾了临床、生化和组织病理学资料。结果患者1为59岁男性，携带SMPD1纯合子突变（c.[Arg610del]），表现为晚期肺部疾病和肝脏脂肪变性。CMR显示双室扩张，收缩功能保留，原生T1值降低，无LGE，提示心肌脂质积累。尽管进行了酶替代治疗，患者还是在22个月后死于肺部并发症。患者2，一名31岁女性，患有复合杂合SMPD1突变（c.[739G > a], c.[1801G > a]），患有肝硬化、血脂异常和稳定的肺部疾病。CMR显示T1值正常，无心脏异常。讨论/结论：本研究比较了两例接受CMR成像的成年NPD-B患者。随访中死亡的第1例患者T1值降低，提示心肌脂质积累，第2例T1值正常，随访无并发症。本文报道的这两例患者刺激了这一领域的研究，因为原生T1可能有助于评估心肌受累。这两个病例也表明基因突变对疾病严重程度的潜在影响。考虑到NPD-B累及心脏的风险，CMR——尤其是T1定位——可能是评估心肌浸润的一种有价值的工具。未来的研究需要探索其与基因型、疾病进展和治疗反应的相关性。

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引用次数: 0

Treatment outcome and associated factors of acute heart failure in East Africa, an Ethiopian perspective: A systematic review and meta-analysis. 东非急性心力衰竭的治疗结果和相关因素，埃塞俄比亚的观点：系统回顾和荟萃分析。

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-10-09 DOI: 10.1016/j.ahjo.2025.100637

Asnake Gashaw Belayneh , Getnet Alemu Andargie , Kedir Seid , Gebeyehu Lakew , Amlaku Nigusie Yirsaw , Mitiku Tefera , Eyob Ketema Bogale , Tadele Fentabel Anagaw , Eneyew Talie Fenta , Destaw Endeshaw , Ousman Adal , Abiyu Abadi Tareke , Natnael Kebede , Lijalem Jemberu , Eyob Getachew

Background

Acute heart failure is a major global health issue, contributing to significant morbidity, mortality, and healthcare costs in Sub-Saharan Africa, including Ethiopia. Despite its burden, comprehensive data on acute heart failure in East Africa remains scarce.

Objective

This systematic review and meta-analysis aimed to synthesize existing evidence on the treatment outcome of acute heart failure and associated factors in East Africa with a focus on Ethiopia.

Methods

Relevant studies were searched in major databases, including PubMed/Medline, Hinari, Science Direct, EMBASE, Scopus, AJOL, Cochrane Library, and local sources from July 5–25, 2024. Both published and unpublished studies in English were included without restrictions on publication date, following PRISMA-2020 protocols. Data quality was assessed using the Newcastle-Ottawa Scale, and meta-analysis was conducted using Stata version 18.

Results

A total of 9 articles involving 1107 participants were included. The pooled mortality of acute heart failure was 16.36 % (95 % CI: 12.39, 20.33) with heterogeneity (I²⁾ value of 85.86 %. Increased blood urea nitrogen (BUN), smoking, and hypotension were the factors significantly associated with the pooled mortality rate of acute heart failure.

Conclusion

This review reveals a high mortality of acute heart failure among hospitalized patients in Ethiopia. Factors such as increased blood urea nitrogen (BUN), smoking, and hypotension contribute to death due to acute heart failure. Therefore, it is necessary to reduce the burden of acute heart failure and improve patient survival in Ethiopia by addressing the identified predictors of poor outcomes and integrating global best practices into local healthcare systems.

急性心力衰竭是一个主要的全球健康问题，在撒哈拉以南非洲（包括埃塞俄比亚）造成了显著的发病率、死亡率和医疗费用。尽管有这种负担，但东非关于急性心力衰竭的全面数据仍然很少。本系统综述和荟萃分析旨在综合有关东非急性心力衰竭治疗结果及相关因素的现有证据，并以埃塞俄比亚为重点。方法检索2024年7月5-25日PubMed/Medline、Hinari、Science Direct、EMBASE、Scopus、AJOL、Cochrane Library等主要数据库及当地文献。根据PRISMA-2020协议，纳入了已发表和未发表的英文研究，没有出版日期限制。使用Newcastle-Ottawa量表评估数据质量，并使用Stata version 18进行meta分析。结果共纳入文献9篇，受试者1107人。急性心力衰竭的总死亡率为16.36% (95% CI: 12.39, 20.33)，异质性（I2）值为85.86%。血尿素氮（BUN）升高、吸烟和低血压是与急性心力衰竭总死亡率显著相关的因素。结论本综述揭示了埃塞俄比亚住院患者急性心力衰竭的高死亡率。血尿素氮（BUN）升高、吸烟和低血压等因素可导致急性心力衰竭死亡。因此，有必要减少急性心力衰竭的负担，并通过解决确定的预后不良的预测因素，提高埃塞俄比亚患者的生存率，并将全球最佳实践纳入当地医疗保健系统。

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引用次数: 0

Rising heart failure mortality in Alzheimer's patients: A CDC wonder database analysis of trends and disparities from 1999 to 2020 阿尔茨海默病患者心力衰竭死亡率上升：疾病预防控制中心对1999年至2020年趋势和差异的数据库分析

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-10-09 DOI: 10.1016/j.ahjo.2025.100634

Anusha Sumbal , Ramish Sumbal , Areeba Ikram , Muskan Asim Taimuri

Introduction

Alzheimer's disease and heart failure are two of the most prevalent disorders in the elderly. While AD–HF comorbidity has been described, the impact of HF on mortality in AD patients is less well characterized. Understanding these trends is vital, as HF-related mortality may represent a preventable contributor with important implications for prognosis, clinical care, and healthcare planning. This study aims to analyze national trends in HF-related mortality in AD patients across demographic and geographical subgroups in the United States from 1999 to 2020.

Methods

A retrospective analysis of CDC WONDER data was conducted. Age-adjusted mortality rates (AAMRs) and crude mortality rates (CMRs) were calculated. Joinpoint regression analysis assessed annual percent change (APC) in mortality trends, with stratification by sub-groups like age, sex, race/ethnicity, and geographic region (including census, rural-urban and state level).

Results

A total of 88,481 HF-related deaths were recorded in AD patients. An almost double increase in AAMR was noted, from 6.5 in 1999 to 12.1 in 2020. Female gender (overall AAMR: 10.2) and NH whites (overall AAMR: 9.8) exhibited the highest overall AAMRs. Geographically, higher mortality was observed in the West (overall AAMR: 10.9) and rural regions (overall AAMR: 11.9). Additionally, people aged 80–84 demonstrated the highest overall CMR (overall CMR: 11.9).

Conclusion

HF-related deaths in Alzheimer's patients have risen sharply over two decades, disproportionately affecting older adults, women, NH Whites, and rural residents. These findings highlight the urgent need for targeted interventions to address rising mortality in this vulnerable population.

阿尔茨海默病和心力衰竭是老年人最常见的两种疾病。虽然AD - HF合并症已被描述，但HF对AD患者死亡率的影响尚不清楚。了解这些趋势至关重要，因为与hf相关的死亡率可能是一种可预防的因素，对预后、临床护理和医疗保健计划具有重要意义。本研究旨在分析1999年至2020年美国不同人口和地理亚组中阿尔茨海默病患者hf相关死亡率的全国趋势。方法对CDC WONDER资料进行回顾性分析。计算年龄调整死亡率（AAMRs）和粗死亡率（CMRs）。结合点回归分析评估了死亡率趋势的年百分比变化（APC），并按年龄、性别、种族/民族和地理区域（包括人口普查、城乡和州一级）等亚组分层。结果AD患者中hf相关死亡共88,481例。AAMR几乎增加了一倍，从1999年的6.5增加到2020年的12.1。女性（总体AAMR为10.2）和NH白人（总体AAMR为9.8）的总体AAMR最高。从地理上看，西部（总体AAMR: 10.9）和农村地区（总体AAMR: 11.9）的死亡率较高。此外，80-84岁的人群表现出最高的总体CMR（总体CMR: 11.9）。结论：20年来，阿尔茨海默病患者中与hf相关的死亡人数急剧上升，主要影响老年人、妇女、NH白人和农村居民。这些发现突出表明，迫切需要采取有针对性的干预措施，以解决这一弱势群体死亡率上升的问题。

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引用次数: 0

National trends in mortality attributable to arrhythmias among adults with obesity in the United States, 1999–2020 1999-2020年美国肥胖成人心律失常死亡率的全国趋势

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-10-08 DOI: 10.1016/j.ahjo.2025.100635

Ibrahim Nagmeldin Hassan , Siddig Yaqub , Muhsin Ibrahim , Nagmeldin Abuassa

Background

Obesity and arrhythmias are escalating public health concerns in the United States. While both have been independently associated with cardiovascular mortality, national trends in obesity-related arrhythmia deaths remain poorly characterized.

Methods

We conducted a population-based cross-sectional study using CDC WONDER mortality data from 1999 to 2020. Adults aged ≥25 years with arrhythmias listed as the underlying cause of death (ICD-10: I47–I49) and obesity as a contributing cause (E66) were included. Age-adjusted mortality rates (AAMRs) were calculated per 100,000 population. Joinpoint regression was used to assess trends and calculate annual percent change (APC) and average annual percent change (AAPC). Analyses were stratified by sex, race/ethnicity, census region, urbanization level, age group, and state.

Results

A total of 67,844 deaths were attributed to obesity-related arrhythmias. The overall AAMR was 1.35 (95 % CI: 1.11–1.60), with a significant AAPC of 6.19 % (95 % CI: 5.68–6.69; p < 0.0001). Males had higher AAMRs than females (1.57 vs. 1.15), with a steeper rise over time. American Indian/Alaska Native (1.61) and Black (1.55) populations experienced the highest mortality rates. Non-metro areas (1.82) and the Midwest (1.63) had the greatest regional burdens. Mortality increased steadily with age, peaking at 4.01 among those aged 75–84 years. State-level AAMRs ranged from 0.77 to 3.29. Most deaths occurred in hospitals or at home.

Conclusion

Obesity-associated arrhythmia mortality has risen with marked heterogeneity; these findings underscore the need for prevention across the life-course and equitable access to rhythm evaluation, evidence-based cardiometabolic care, and targeted screening.

背景：在美国，肥胖和心律失常是日益严重的公共卫生问题。虽然两者都与心血管死亡率独立相关，但与肥胖相关的心律失常死亡的全国趋势仍不清楚。方法：我们使用1999年至2020年CDC WONDER死亡率数据进行了一项基于人群的横断面研究。年龄≥25岁、心律失常被列为潜在死亡原因（ICD-10: I47-I49）和肥胖被列为致病原因（E66）的成年人被纳入研究。计算每10万人的年龄调整死亡率（AAMRs）。采用连接点回归评估趋势，计算年变化百分比（APC）和平均年变化百分比（AAPC）。分析按性别、种族/民族、人口普查地区、城市化水平、年龄组和州进行分层。结果67,844例死亡归因于肥胖相关心律失常。总体AAMR为1.35 (95% CI: 1.11-1.60)， AAPC为6.19% （95% CI: 5.68-6.69; p < 0.0001）。男性的aamr高于女性（1.57比1.15），随着时间的推移，上升幅度更大。美洲印第安人/阿拉斯加原住民（1.61）和黑人（1.55）的死亡率最高。非都市地区（1.82）和中西部地区（1.63）的地区负担最重。死亡率随着年龄的增长而稳步上升，在75-84岁的人群中达到4.01的峰值。国家级aamr为0.77 ~ 3.29。大多数死亡发生在医院或家中。结论肥胖相关性心律失常死亡率呈上升趋势，且异质性明显；这些发现强调了在整个生命过程中预防和公平获得节律评估、循证心脏代谢护理和有针对性筛查的必要性。

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