BMC Cardiovascular Disorders最新文献

Background: The combined impact of the systemic immune-inflammation index (SII) and the triglyceride-glucose index (TyG) on short- and long-term outcomes in patients with coronary heart disease (CHD) remains unclear. This study aimed to investigate the association between the SII combined with the TyG index and mortality risk in CHD patients.

Methods: This study included 970 CHD patients from the MIMIC-IV database. Participants were divided into four quartiles based on median SII and TyG values: T1 (low SII and low TyG), T2 (low SII and high TyG), T3 (high SII and low TyG), and T4 (high SII and high TyG). The combined impact of these indices on CHD patient prognosis was explored using Cox proportional hazards models, Kaplan-Meier survival curves, receiver operating characteristic (ROC) curves, and subgroup analyses.

Results: Compared with the T1 group, the T4 group showed a significantly increased risk of mortality. Multivariate Cox regression analysis revealed the highest 30-day (HR = 2.446, 95% CI 1.366-4.382, p = 0.003) and 1-year (HR = 1.586, 95% CI 1.054-2.387, p = 0.027) mortality risks in the T4 group. ROC curves further confirmed that the combined SII-TyG index demonstrated superior predictive capability for both short-term (AUC = 0.728, 95% CI 0.677-0.778) and long-term (AUC = 0.742, 95% CI 0.703-0.780) outcomes in CHD patients compared to the SII or TyG index alone. Subgroup analyses indicated that the predictive value of the combined index demonstrated considerable universality across different clinical strata. Furthermore, incorporating the combined index into baseline models moderately improved mortality prediction performance. Similarly, a cohort of 1,621 CHD patients from the eICU2.0 database yielded comparable findings: elevated SII and TyG indices correlated with increased in-hospital mortality risk (T4 HR = 3.378, 95% CI 1.716-6.649, p < 0.001), and ROC curve analysis confirmed that combined assessment demonstrated the highest predictive efficacy (AUC = 0.800, 95% CI 0.760-0.840).

Conclusion: In summary, the combined assessment of SII and TyG indices assists clinicians in identifying high-risk populations and improving outcomes for patients with CHD.

Patent foramen ovale (PFO) is a common congenital cardiac anomaly, and ultra-long tunnel PFO (> 20 mm) presents a significant interventional challenge despite routine standard closure. A 68-year-old female with recurrent headaches, chest pain history, and prior right coronary artery stenting was confirmed to have a 37-mm ultra-long tunnel PFO via transesophageal echocardiography (TEE) and digital subtraction angiography (DSA). After initial percutaneous closure failure, the patient was successfully treated with a modified trans-tunnel puncture technique and deployment of an Abbott 18/25 mm Amplatzer PFO Occluder. Follow-up showed gradual resolution of residual shunt, with no shunt detected by June 2025. The imaging-guided modified trans-tunnel puncture technique is an effective strategy for complex ultra-long tunnel PFOs.

Background: This study employed four-dimensional automated left atrial quantitative analysis (4D Auto LAQ) technology to assess left atrial structure and function in patients with H-type hypertension and to investigate the impact of serum homocysteine (Hcy) level on the left atrium in patients with primary hypertension.

Methods: A total of 173 patients with primary hypertension newly diagnosed between December 2023 and December 2024 were enrolled and divided into two groups: H-type hypertension (n = 85) and non-H-type hypertension (n = 88). Additionally, 60 healthy volunteers were recruited as the control group.

Results: The results showed that compared with the non-H-type hypertension group and the control group, the H-type hypertension group exhibited statistically significant differences in Hcy, total cholesterol, triglycerides, estimated glomerular filtration rate (eGFR), and uric acid (p < 0.05). Additionally, there was a decrease (p < 0.05) in left atrial reservoir systolic longitudinal strain (LASr), left atrial systolic longitudinal strain (LASct), left atrial reservoir systolic circumferential strain (LASr-c), and left atrial systolic circumferential strain (LASct-c). Multiple linear regression analysis identified plasma Hcy levels as an independent associated factor for decreased left atrial strain parameters, including LASr (β=-0.246, p < 0.001), LASct (β=-0.279, p < 0.001), LASr-c (β=-0.333, p < 0.001), and LASct-c (β=-0.303, p < 0.001).

Conclusions: In conclusion, patients with H-type hypertension have decreased left atrial strain parameters, and when serum Hcy levels rise, the degree of strain dysfunction gradually gets worse. This suggests that these parameters could be used as an early indicator of left atrial myocardial injury in patients with H-type hypertension.