American heart journal最新文献

{"title":"PRospective evaluation of the European Society of Cardiology 0/1h-algorithm`s safety and efficacy for triage of patients with suspected myocardial infarction (PRESC1SE-MI): Rationale and design of a prospective international multicenter stepped-wedge cluster randomized controlled trial","authors":"Jasper Boeddinghaus MD ,&nbsp;Paolo Bima MD ,&nbsp;Luca Crisanti MD ,&nbsp;Dagmar I Keller MD ,&nbsp;Ksenija Slankamenac MD PhD ,&nbsp;Michael Christ MD ,&nbsp;Philipp Schuetz MD ,&nbsp;Andrea Wiencierz PhD ,&nbsp;Ivo Strebel PhD ,&nbsp;Julia Reinhardt PhD ,&nbsp;Iryna Vyshnevska MD ,&nbsp;Tzu-Ying Tsao MSc ,&nbsp;Felix Mahfoud MD ,&nbsp;Maria Pia Ruggieri MD ,&nbsp;Stephan Steuer MD ,&nbsp;Òscar Miró MD ,&nbsp;Veli-Pekka Harjola MD ,&nbsp;Fulvio Morello MD PhD ,&nbsp;Peiman Nazerian MD ,&nbsp;Dominik Roth MD PhD ,&nbsp;John Parissis MD","doi":"10.1016/j.ahj.2025.107299","DOIUrl":"10.1016/j.ahj.2025.107299","url":null,"abstract":"<div><h3>Background</h3><div>International practice guidelines recommend the more rapid European Society of Cardiology (ESC) 0/1h-algorithm for the triage of patients with suspected myocardial infarction (MI) as the preferred option and consider the ESC 0/3h-algorithm as an alternative. However, many centers worldwide have not yet adopted the ESC 0/1h-algorithm in clinical practice due to uncertainty which approach best balances safety and efficacy.</div></div><div><h3>Methods</h3><div>PRESC1SE-MI (PRospective Evaluation of the European Society of Cardiology 0/1h-algorithm`s Safety and Efficacy for Triage of Patients with Suspected Myocardial Infarction) is an international, investigator-initiated multicenter, stepped-wedge, cluster randomized controlled trial. At least 52,156 consecutive adult patients with nontraumatic acute chest discomfort and suspected MI presenting to the Emergency Department (ED) will be enrolled. Sites still using the ESC 0/3h-algorithm as standard-of-care will be randomized to implement the more rapid ESC 0/1h-algorithm at an early or late implementation step. During the validation phase, participating sites continue to use the ESC 0/3h-algorithm. The co-primary outcomes are a composite of type 1 MI or all-cause death at 30 days (safety), and the length of stay in the ED (efficacy). The trial is designed to show noninferiority for safety and superiority for efficacy, with a power of at least 90%.</div></div><div><h3>Conclusions</h3><div>PRESC1SE-MI is the largest international multicenter trial to date evaluating the safety and the efficacy of the implementation of the more rapid ESC 0/1h-algorithm at late adopting centers across multiple countries and healthcare systems. Its findings have the potential to improve patient care and reduce healthcare costs.</div><div><strong>Trial registration:</strong> <span><span>https://clinicaltrials.gov/study/NCT05649384</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"292 ","pages":"Article 107299"},"PeriodicalIF":3.5,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145429933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A just-in-time adaptive mobile application intervention to reduce sodium intake and blood pressure in patients with hypertension: Rationale and design of the LowSalt4Life 2 trial","authors":"Michael P. Dorsch PharmD, MS ,&nbsp;Walter Dempsey PhD ,&nbsp;Amy Krambrink MS ,&nbsp;Sabah Ganai MPH ,&nbsp;Kaitlyn M. Greer PhD ,&nbsp;Mohamed S. Ali PharmD, SM ,&nbsp;Chelsie Gesierich MPH ,&nbsp;Margaret O’Neill BA ,&nbsp;Brahmajee K. Nallamothu MD, MPH ,&nbsp;Scott L. Hummel MD, MS","doi":"10.1016/j.ahj.2025.107294","DOIUrl":"10.1016/j.ahj.2025.107294","url":null,"abstract":"<div><h3>Background</h3><div>Excess dietary sodium intake is a major contributor to hypertension (HTN) and cardiovascular disease in the U.S., yet most Americans exceed recommended sodium intake levels. Despite the established benefits of sodium reduction, behavioral adherence remains a challenge. Just-in-time adaptive interventions (JITAIs) provide a novel mobile health (mHealth) strategy to support low-sodium choices in real-time at restaurants and grocery stores.</div></div><div><h3>Methods</h3><div>LowSalt4Life 2 is a 6-month randomized controlled trial evaluating a mobile application-based sodium-focused JITAI among adults with HTN. In phase one, participants were randomized 1:1 to either the LowSalt4Life app with JITAI (App+JITAI) or the app alone. At 2 months, the App+JITAI group was re-randomized to either continue with the standard JITAI or receive a personalized JITAI (pJITAI) informed by reinforcement learning based on prior engagement. The primary outcome was change in systolic blood pressure (SBP) at 2 months. Secondary outcomes included changes in BP medication, dietary sodium intake, and engagement metrics.</div></div><div><h3>Results</h3><div>As of October 2025, 410 participants had been enrolled and completed follow-up. The trial's final results are anticipated in Spring 2025. Primary analysis focuses on the change in SBP between the App+JITAI and App-only groups, as well as the added value of personalization in the second study phase.</div></div><div><h3>Conclusions</h3><div>LowSalt4Life 2 tests a scalable, context-aware digital intervention designed to reduce dietary sodium and improve BP management. By personalizing engagement based on user behavior, this study seeks to advance mHealth strategies for HTN self-management and inform future interventions targeting dietary behaviors in real-world settings.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"292 ","pages":"Article 107294"},"PeriodicalIF":3.5,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145399795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of obesity subphenotypes with indices of cardiac remodeling in the Framingham heart study","authors":"William J. He MD MHS ,&nbsp;Brenton R. Prescott MS ,&nbsp;Vanessa Xanthakis PhD ,&nbsp;Gary F. Mitchell MD ,&nbsp;Susan Cheng MD ,&nbsp;Ramachandran S. Vasan MD","doi":"10.1016/j.ahj.2025.107292","DOIUrl":"10.1016/j.ahj.2025.107292","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have reported that obesity-related metabolic abnormalities (eg, diabetes and hypertension) lead to myocardial dysfunction and adverse cardiac remodeling. However, it is unclear whether such cardiac remodeling is from obesity or obesity-related metabolic abnormalities. We hypothesize that overweight and obesity are associated with adverse cardiac remodeling independent of associated metabolic abnormalities.</div></div><div><h3>Methods</h3><div>We evaluated 6,639 participants from the Framingham Heart Study who underwent echocardiography and had no prevalent cardiovascular disease. Individuals were classified into 6 obesity sub-phenotypes based on metabolic health (metabolically healthy or metabolically unhealthy) and body mass index (normal weight, overweight, or obese). Obesity subphenotypes were related to echocardiographic measures using multivariable regression analyses.</div></div><div><h3>Results</h3><div>Mean age was 49 years and 55% were women. Overweight and obesity were consistently associated with adverse cardiac remodeling in both metabolic healthy and unhealthy participants. Among metabolically healthy participants, compared to the normal weight group (referent), overweight and obesity were significantly associated with increased left ventricular mass (11.6 and 21.4 gm), left atrium end-systolic dimension (0.27 and 0.48 cm), global longitudinal strain (0.82 and 1.06%), and the ratio of early diastolic trans-mitral flow velocity to early diastolic mitral annulus velocity (0.35 and 0.87) (all <em>P</em> &lt; .001). Additionally, obesity was significantly associated with mitral annular plane systolic excursion (0.08 cm, <em>P</em> &lt; .001) and relative wall thickness (0.01, <em>P</em> = .001) compared to the normal weight referent group.</div></div><div><h3>Conclusions</h3><div>Increasing body weight was associated with adverse cardiac remodeling regardless of metabolic health status, which suggests that obesity may directly increase the risk of adverse cardiac remodeling.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"292 ","pages":"Article 107292"},"PeriodicalIF":3.5,"publicationDate":"2025-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal versus conventional radial large-bore access for percutaneous coronary intervention of complex coronary lesions: Rationale and design of the DISCO COMPLEX randomized superiority trial","authors":"Juan F. Iglesias MD ,&nbsp;Gregor Leibundgut MD ,&nbsp;Dik Heg PhD ,&nbsp;Gabriele L. Gasparini MD ,&nbsp;Grigorios Tsigkas MD, PhD ,&nbsp;Claudiu Ungureanu MD ,&nbsp;Giuseppe Colletti MD ,&nbsp;Sophie Degrauwe MD ,&nbsp;Panagiotis Xaplanteris MD, PhD ,&nbsp;Karsten Schenke MD ,&nbsp;Alexandru Achim MD ,&nbsp;Maarten AH van Leeuwen MD, PhD ,&nbsp;Maia Muresan MSc ,&nbsp;Shigeru Saito MD ,&nbsp;Gregory A. Sgueglia MD, PhD ,&nbsp;Adel Aminian MD","doi":"10.1016/j.ahj.2025.107291","DOIUrl":"10.1016/j.ahj.2025.107291","url":null,"abstract":"<div><h3>Rationale</h3><div>Distal radial access (DRA) has emerged as a promising alternative to conventional transradial access (TRA) for coronary angiography and percutaneous coronary intervention (PCI). However, existing randomized evidence on DRA primarily involves low-risk patients undergoing diagnostic angiography or noncomplex PCI using ≤6 French (Fr) introducer sheaths. The clinical benefits of DRA among patients undergoing PCI for complex coronary lesions using large-bore guide catheters remain therefore uncertain.</div></div><div><h3>Design</h3><div>DISCO COMPLEX is an investigator-initiated, prospective, multicenter, international, open-label, randomized, controlled trial with a blinded outcome assessment and superiority design. The trial will compare in a 1:1 ratio large-bore DRA versus conventional TRA using a 7-Fr introducer sheath in 708 patients undergoing PCI for complex coronary lesions (chronic total occlusions, left main disease, heavily calcified lesions, or complex bifurcations) with a 7-Fr guide catheter. The primary hypothesis is that large-bore DRA is superior to conventional TRA with respect to the incidence of forearm radial artery occlusion (RAO) assessed by Doppler ultrasound at hospital discharge. The prespecified DISCOPHILE COMPLEX hand function substudy is a noninferiority trial evaluating whether large-bore DRA is not inferior to conventional TRA with respect to change in full-<em>Disabilities of the Arm, Shoulder and Hand</em> (DASH) questionnaire score from baseline to 12 months in participants of the DISCO COMPLEX trial.</div></div><div><h3>Enrolment status</h3><div>The trial aims to recruit a total of 708 patients from 10 to 15 participating centers across Europe. The first patient was enrolled on August 31, 2023. As of August 20, 2025, 385 patients have been included.</div></div><div><h3>Conclusion</h3><div>DISCO COMPLEX is the first randomized clinical trial designed to test the superiority of large-bore DRA over conventional TRA in reducing RAO rates among patients undergoing complex PCI with 7-Fr guide catheters.</div></div><div><h3>Trial Registration</h3><div>Clinicaltrials.gov: Identifier, NCT05490238.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"292 ","pages":"Article 107291"},"PeriodicalIF":3.5,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Worsening heart failure events in adults with mild-to-moderate chronic kidney disease","authors":"Linda Ye MD ,&nbsp;Michael P. Girouard MD, MBA ,&nbsp;Alan S. Go MD ,&nbsp;Jane Y. Liu MPH ,&nbsp;Rishi V. Parikh MPH ,&nbsp;Thida C. Tan MPH ,&nbsp;Emily S. Lee MD ,&nbsp;Grace Sun BA ,&nbsp;Rami Halaseh MD ,&nbsp;Ankeet S. Bhatt MD, MBA, ScM ,&nbsp;Leonid Pravoverov MD ,&nbsp;Sijie Zheng MD ,&nbsp;Jana Svetlichnaya MD ,&nbsp;Jesse K. Fitzpatrick MD ,&nbsp;Harshith R. Avula MD, MPH ,&nbsp;Keane K. Lee MD, MS ,&nbsp;Sirtaz Adatya MD ,&nbsp;David Ouyang MD ,&nbsp;Parag Goyal MD, MSc ,&nbsp;Alexander T. Sandhu MD, MS ,&nbsp;Andrew P. Ambrosy MD, MPH","doi":"10.1016/j.ahj.2025.107290","DOIUrl":"10.1016/j.ahj.2025.107290","url":null,"abstract":"<div><h3>Background</h3><div>Chronic kidney disease (CKD) is a major risk factor for heart failure (HF). However, the burden of worsening HF (WHF) events among adults with mild-to-moderate CKD has not been well described.</div></div><div><h3>Objectives</h3><div>This study assessed the burden of WHF in a contemporary cohort of adults with mild-to-moderate CKD.</div></div><div><h3>Methods</h3><div>We identified adults with mild-to-moderate CKD (eGFR 30-59 mL/min/1.73m² or eGFR ≥60 mL/min/1.73m² with albuminuria) within a large, integrated healthcare delivery system from 2012 to 2021. Outcomes included hospitalizations, emergency department visits, and outpatient encounters for WHF, stratified by HF status and level of CKD.</div></div><div><h3>Results</h3><div>Among 375,495 adults with mild-to-moderate CKD, mean age was 64 ± 16 years, 54% were women, mean eGFR was 76 ± 26 mL/min/1.73m², and 6.5% had prior known HF. CKD stages G1A2 (31.6%), G2A2 (24.9%), and G3aA1 (25.1%) were most prevalent. Rates (95% CI) per 100 person-years for WHF events were 1.85 (1.83-1.87) for hospitalizations, 0.85 (0.84-0.86) for emergency department visits, and 0.83 (0.81-0.84) for outpatient encounters, resulting in a cumulative rate of 2.42 (2.40-2.44). Event rates were higher at lower eGFR and higher albuminuria levels.</div></div><div><h3>Conclusions</h3><div>WHF is a common source of morbidity in adults with earlier stage CKD, and particularly high in those with lower eGFR and greater albuminuria. These findings underscore the importance of implementing available and emerging cardioprotective and renoprotective therapies in this high-risk population.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"292 ","pages":"Article 107290"},"PeriodicalIF":3.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional coronary angiogram findings in angina with non-obstructive coronary arteries patients with coronary slow flow","authors":"Olivia Girolamo BMedSc ,&nbsp;Muhammad Dzafir Ismail MBBS, MMed ,&nbsp;Rosanna Tavella BSc, PhD ,&nbsp;Eng Lee Ooi MBBS, PhD ,&nbsp;Sivabaskari Pasupathy BSc, PhD ,&nbsp;Sarena La BMedSc ,&nbsp;Abdul Sheikh MBBS, MD ,&nbsp;Christopher Zeitz MBBS, PhD ,&nbsp;John Beltrame BSc, BMBS, PhD","doi":"10.1016/j.ahj.2025.107287","DOIUrl":"10.1016/j.ahj.2025.107287","url":null,"abstract":"<div><h3>Background</h3><div>The Coronary Slow Flow Phenomenon (CSFP) is considered a coronary microvascular disorder and has been defined as a corrected thrombolysis in myocardial infarction frame count (cTFC) ≥25 frames. Recent invasive physiology studies have reported that cTFC is not a surrogate marker for coronary microvascular dysfunction (CMD), defined by an abnormal Coronary Flow Reserve (CFR), questioning the integrity of CSFP. This study evaluates the Functional Coronary Angiography (FCA) findings of patients with and without CSFP, as well as the relationship between cTFC and invasive coronary functional measures.</div></div><div><h3>Methods</h3><div>FCA utilizing a pressure-Doppler flow wire during adenosine infusion, and acetylcholine provocation, was undertaken in 103 patients with angina and non-obstructive coronary artery disease (&lt;50% stenosis; ANOCA).</div></div><div><h3>Results</h3><div>The FCA findings revealed CMD (i.e. CFR&lt;2) in 43%, inducible coronary artery spasm (58%) and microvascular spasm (13%) in patients with the CSFP (<em>n</em> = 69), which was similar to those without CSFP (<em>n</em> = 34). However, the CSFP patients had a lower resting coronary blood flow velocity (19 ± 7 vs 23 ± 7cm/s, <em>P = .</em>009) with higher resting microvascular resistance (5.8 ± 1.9 vs 4.4 ± 1.7mmHg/cm/s, <em>P = .</em>006) and higher hyperemic microvascular resistance (2.35 ± 1.09 vs 1.94 ± 0.93, <em>P = .</em>049), despite a similar hyperemic CFR (2.25 ± 0.84 vs 2.26 ± 0.58, <em>P = .</em>971) compared to those without CSFP. Furthermore, the cTFC as a continuous measure, correlated with resting coronary blood flow, resting/hyperemic resistance but not CFR.</div></div><div><h3>Conclusion</h3><div>The conventional marker of CMD (i.e. CFR &lt;2) was similar in patients with/without the CSFP. However alternative hemodynamic markers of impaired coronary microvascular function were abnormal in patients with the CSFP, including resting/hyperemic coronary microvascular resistance. Moreover, cTFC is a simple semi-quantitative marker correlated with coronary microvascular resistance and thus has clinical utility in the diagnosis of the CSFP.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"292 ","pages":"Article 107287"},"PeriodicalIF":3.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/S0002-8703(25)00343-6","DOIUrl":"10.1016/S0002-8703(25)00343-6","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"291 ","pages":"Page iv"},"PeriodicalIF":3.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statistical methodological limitations and improvement suggestions in the study of vitamin D deficiency and cardiovascular mortality after heart transplantation","authors":"Haiying Hu BSc,&nbsp;Linjun Wang BSc","doi":"10.1016/j.ahj.2025.08.015","DOIUrl":"10.1016/j.ahj.2025.08.015","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"291 ","pages":"Pages 216-217"},"PeriodicalIF":3.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bioimpedance phase angle is associated with increased heart failure hospitalization risk","authors":"Kivanc Ozonat PhD ,&nbsp;Corey Centen B.Eng ,&nbsp;Sarah Smith B.Eng ,&nbsp;V. Burak Aydemir PhD ,&nbsp;Marat Fudim MD, MHS ,&nbsp;Adam D. DeVore MD, MHS","doi":"10.1016/j.ahj.2025.107288","DOIUrl":"10.1016/j.ahj.2025.107288","url":null,"abstract":"<div><h3>Background</h3><div>Outcomes for patients living with heart failure (HF) remain poor with high rates of death and hospitalization due to worsening HF. Noninvasive tools may be useful to identify patients at risk for disease progression before these outcomes occur. For example, loss of cell mass and compromised cell membrane integrity throughout the body are associated with chronic disease, mortality, frailty, and malnutrition. As the cell membrane loses its integrity, its electrical capacitance decreases, lowering bioelectrical phase angle. Data collected during the SCALE-HF 1 study (NCT04882449) was used to evaluate bioelectrical phase angle as a marker for heart failure (HF) hospitalization risk. Phase angle was measured by the FDA-cleared Bodyport Cardiac Scale.</div></div><div><h3>Methods</h3><div>SCALE-HF 1 was a multicenter, prospective, observational study, investigating HF event prediction. Baseline phase angle was measured during the first week in the study with the patient standing barefoot on the Cardiac Scale at home for approximately 20 seconds. HF hospitalizations were independently adjudicated. The analysis was based on univariable and multivariable Cox regression models adjusted for age, sex, race, body mass index (BMI), left ventricular ejection fraction (LVEF), inpatient status at enrollment, and selected comorbidities and laboratory tests.</div></div><div><h3>Results</h3><div>329 participants with HF were enrolled across 8 US sites with 238 patient-years of follow-up. 312 (95%) of the participants had a baseline phase angle, and 57 (18%) of those had a HF hospitalization during the follow-up period. Participants with baseline phase angle in the lowest quartile (suggesting worse cell membrane integrity) were at increased risk for HF hospitalization compared to participants with baseline phase angle in the highest quartile (Hazard ratio: 3.44, 95% CI: 1.55 to 7.63, <em>P</em> = .002). When adjusted for risk factors selected from age, sex, race, BMI, LVEF, laboratory tests and comorbidities in the multivariable model, participants with baseline phase angle in the lowest quartile continued to be at increased risk for HF hospitalization compared to participants with baseline phase angle in the highest quartile (Hazard ratio: 3.51, 95% CI: 1.73 to 7.12, <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Phase angle was found to be independently associated with HF hospitalization risk. The noninvasive measurement, acquired with a familiar scale form factor, may help guide remote care and triage.</div></div><div><h3>Trial Registration</h3><div>ClinicalTrials.gov NCT04882449. <span><span>https://clinicaltrials.gov/study/NCT04882449</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"292 ","pages":"Article 107288"},"PeriodicalIF":3.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to letter by Hu regarding article, “Statistical Methodological Limitations and Improvement Suggestions in the Study of Vitamin D Deficiency and Cardiovascular Mortality After Heart Transplantation.”","authors":"Matthew Gold MD ,&nbsp;Sarah Kulkarni MSPH ,&nbsp;Arshed Quyyumi MD","doi":"10.1016/j.ahj.2025.08.016","DOIUrl":"10.1016/j.ahj.2025.08.016","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"291 ","pages":"Pages 218-219"},"PeriodicalIF":3.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}