Cardiology最新文献

Background: Heart failure (HF) and various arrhythmias frequently co-occur in clinical practice, suggesting shared pathophysiological mechanisms. However, the extent and nature of their common genetic architecture remains incompletely understood. This study aimed to systematically investigate the genetic correlations and shared causal loci between HF-related traits and multiple arrhythmia phenotypes.

Methods: We utilized GWAS summary statistics from European cohorts to analyze HF-related traits and ten common arrhythmias. Global genetic correlations were assessed using LDSC and HDL. Local genetic correlations were further investigated using LAVA, HESS, and SUPERGNOVA to identify regional overlaps. Pleiotropic loci were identified using PLACO, with Bayesian colocalization analysis (stringent threshold PP.H4 ≥ 0.75) to assess shared causality. Bidirectional Mendelian randomization (MR) was conducted to explore causal relationships, utilizing a discovery threshold (P < 5×10⁻⁶) and a validation threshold (P < 5×10⁻⁸) with independent FinnGen data.

Results: Significant genome-wide genetic correlations were identified between HF and seven arrhythmia traits, with the strongest association for atrial fibrillation (LDSC rg = 0.42, P = 5.1×10⁻¹⁸; HDL rg = 0.63, P = 5.9×10⁻³⁷). Local genetic correlation analyses identified multiple genomic regions of significant overlap, particularly converging on a major hotspot at the 4q25/PITX2/ENPEP locus across all three methods. Pleiotropic analysis identified several high-confidence shared loci, including regions harboring BAG3 (PP.H4 = 0.990) and ZFHX3 (PP.H4 = 0.938). Bidirectional MR revealed significant causal effects of AF on HF development (IVW OR = 1.22, P = 4.83×10⁻¹⁸) and HF on reduced heart rate variability (P = 1.86×10⁻⁴), both validated in independent cohorts.

Conclusions: Our findings demonstrate substantial and complex shared genetic architecture between HF and multiple arrhythmia phenotypes. These insights identify specific pleiotropic genes, regional correlation hotspots, and causal pathways, potentially informing future precision medicine approaches for cardiovascular disease prevention and treatment.

Introduction Continuous monitoring of cardiac function may contribute to improving clinical outcomes in heart failure (HF) patients. A fiber-optic micro-vibration sensing system (FO-MVSS) that was previously developed by our group could make possible the non-contact and continuous measurement of the myocardial performance index (MPI) to assess cardiac function. However, the utility of MPI obtained by FO-MVSS (MPIFO-MVSS) in HF patients requires investigation. Methods Utilizing a case-control design, 72 HF patients and 72 control patients matched for age, gender and body mass index were recruited. Both FO-MVSS and echocardiography were used to measure the duration of the various phases of the cardiac cycle, thereby deriving the corresponding MPI. The MPIFO-MVSS of 23 hospitalized patients with HF was continuously monitored to evaluate its predictive value for the improvement of cardiac function. Results The MPIFO-MVSS was in excellent agreement with the MPI obtained by echocardiography (MPIecho) (intra-class correlation coefficient: 0.94, p<0.001). The MPIFO-MVSS exhibited statistically significant correlations with left ventricular ejection fraction (LVEF) (r=-0.78, p<0.001) and N-terminal prohormone brain natriuretic peptide (NT-proBNP) (r=0.66, p<0.001). The MPIFO-MVSS had an excellent performance in discriminating HF patients from control patients, with an area under the curve (AUC) of 0.98 (p<0.001). Moreover, among continuously monitored patients, the change in MPIFO-MVSS was predictive of clinical outcomes (the kappa coefficient: 0.91, p<0.001). Conclusion Our study presents a novel approach to using non-contact MPIFO-MVSS for continuous cardiac function evaluation in patients with HF. The MPIFO-MVSS may serve as an accurate, sensitive, and non-invasive indicator of cardiac dysfunction.

Background: Ischemic heart disease (IHD) is a leading cause of global cardiovascular mortality. Left ventricular (LV) remodeling, quantifiable through changes in left ventricular mass index (LVMI) and relative wall thickness (RWT), is a pivotal pathological process linking ischemia to clinical outcomes.

Objectives: This narrative review aims to synthesize the current evidence on the pathophysiological mechanisms, prognostic value, and clinical implications of LV mass, LVMI, and RWT across the spectrum of IHD.

Methods: We performed a comprehensive narrative synthesis of evidence from relevant studies identified through systematic searches of major biomedical databases.

Results: Convergent evidence confirms that LVMI and RWT are robust, independent predictors of adverse cardiovascular events in IHD. Concentric hypertrophy (elevated LVMI with elevated RWT) consistently confers the highest risk across imaging modalities. These parameters provide incremental prognostic value beyond traditional risk factors, and their dynamic trajectory offers critical insights into therapeutic response.

Conclusions: The integrated assessment of LVMI and RWT is crucial for risk stratification and personalized management in IHD. Future research should prioritize establishing standardized, modality-specific therapeutic targets and validating their role as surrogate endpoints in clinical trials.

Introduction: In recent years, increasing evidence has highlighted the potential of remote management in cardiovascular diseases, with growing recognition of its feasibility and clinical value supporting its broad future application. This study aimed to investigate the efficacy of remote management for patients with heart failure (HF) in eastern China.

Methods: A single-center, prospective, nonrandomized controlled trial enrolled 433 patients with HF, comprising 52 opting for remote management and 381 receiving usual care. Propensity score matching (1:2) yielded 95 patients (37 intervention and 58 control) for analysis. The intervention comprised a multi-level digital health ecosystem (WeChat mini-program and centralized digital health management platform), structured health monitoring (weight, blood pressure, heart rate, and oxygen saturation), and education. The primary outcome includes a composite of cardiovascular mortality and HF-related rehospitalization.

Results: The composite primary outcome occurred in 11 (30%) patients receiving intervention and 24 (41%) controls over a maximum 24-month follow-up period. The intervention group demonstrated a statistically significant reduction in the percentage of days lost due to unplanned HF rehospitalization or all-cause death (p = 0.049). Numerically lower rates were observed for HF-related rehospitalization, cardiovascular mortality, and all-cause mortality, along with higher quality of life scores, although with no statistical significance.

Conclusion: Remote management demonstrated feasibility and potential clinical benefits, particularly in reducing the cumulative burden of illness. Further, it provides a foundation for integration into primary healthcare systems to optimize resource allocation and improve long-term patient outcomes.

Backgrounds: Percutaneous IntraMyocardial Septal Radiofrequency Ablation (PIMSRA, Liwen procedure) is a novel septal reduction therapy (SRT) for drug-refractory hypertrophic obstructive cardiomyopathy (HOCM) patients. Due to the lack of SRT risk tools, EuroSCORE-Ⅱ, STS-PROM and HCM Risk-SCD have been considered as potential alternatives for risk assessment prior to SRT. We aim to evaluate the predictive value of these models for short-term adverse events in HOCM patients undergoing PIMSRA.

Methods: A total of 571 HOCM patients treated with PIMSRA in Xijing Hospital from October 2016 to June 2024 were retrospectively enrolled and their risk scores were calculated. The primary outcome was the 30-day incidence of major adverse cardiovascular events (MACE), including a composite of all-cause death, cardiac tamponade, arrhythmic events, cardiogenic shock and stroke.

Results: During the 30-day follow-up, 61 (10.7%) patients experienced MACE. Multivariate analysis revealed that EuroSCORE-Ⅱ (OR = 2.30), STS-PROM (OR= 1.18), history of syncope and peak left ventricular outflow tract (LVOT) gradient were independently associated with MACE risk after PIMSRA. The area under the receiver operating-characteristic curve (AUROC) values were 0.657 (95% CI: 0.581-0.733) for EuroSCORE-Ⅱ, 0.623 (95% CI: 0.551-0.696) for STS-PROM, and 0.550 (95% CI: 0.469-0.631) for HCM Risk-SCD. Calibration metrics for three models were favorable because of the low incidence of MACE. DCA showed limited benefit to using any score.

Conclusions: EuroSCORE-Ⅱ, STS-PROM, history of syncope and peak LVOT gradient were independently associated with increased risk of 30-day MACE following PIMSRA. Developing SRT-specific risk prediction models is essential for optimizing SRT risk assessment.

Introduction: Saphenous vein graft (SVG) failure is a key determinant of long-term outcomes after coronary artery bypass grafting (CABG), particularly in individuals with multivessel disease or diabetes. This meta-analysis aimed to evaluate whether the no-touch SVG harvesting technique reduces graft occlusion and improves cardiovascular outcomes compared with the conventional approach.

Methods: A comprehensive literature search of PubMed, Embase, Web of Science, and the Cochrane Library was conducted up to May 2025 to identify randomized controlled trials (RCTs) comparing the no-touch and conventional saphenous vein harvesting techniques in CABG. A random-effects model was used for meta-analysis, and the certainty of evidence was evaluated using the GRADE framework.

Results: Eight RCTs involving 4,258 CABG patients (no-touch: 2,144; conventional: 2,114) were included. The no-touch technique significantly reduced the risk of vein graft occlusion (RR, 0.59; 95% CI: 0.47-0.73; P < 0.00001; I² = 31%). Subgroup analyses confirmed the consistency of this effect across regions and follow-up durations. Although differences in secondary outcomes-including all-cause and cardiovascular mortality, myocardial infarction, stroke, and repeat revascularization-were not statistically significant, most effect estimates favored the no-touch approach. The certainty of evidence was rated as moderate for the primary and several secondary outcomes according to the GRADE assessment.

Conclusion: This meta-analysis shows that no-touch saphenous vein harvesting is associated with a lower risk of graft occlusion compared with conventional harvesting in CABG. However, current randomized evidence does not demonstrate a definitive improvement in major cardiovascular outcomes. These findings highlight the need to balance angiographic benefits against potential trade-offs and underscore the need for large-scale, event-driven randomized trials to clarify the net clinical benefit of this technique.

Introduction: Oscillatory breathing (OB) observed during cardiopulmonary exercise testing (CPX) is a critical phenomenon, especially in patients with heart failure. Patients with cardiovascular diseases with OB usually present with cyclic changes not only in ventilation (VE) but also in oxygen uptake (VO2), carbon dioxide output (VCO2), end-tidal partial pressure of carbon dioxide (PETCO₂, reflecting dynamic changes in arterial PCO₂), and other respiratory gas variables. We aimed to evaluate whether the phase difference between the respiratory gas variables obtained from CPX is correlated with cardiopulmonary function.

Methods: From a retrospective analysis of 1,740 patients with cardiovascular diseases who underwent CPX, 42 patients (65±13 years) with clear OB were selected. Oscillatory changes were observed in VE, VO2, VCO2, PETCO2, and end-tidal oxygen tension (PETO2) in all patients. PETCO2 and PETO2 oscillated almost simultaneously, although their peak and nadir were reversed. Oscillatory changes in PETCO2 and PETO2 preceded those in the other cardiopulmonary variables. After the peak of oscillating PETCO2, the oscillations of VO2, VCO2, and VE followed this order.

Results: The phase difference between PETCO2 and VE was significantly and positively correlated with the VE-VCO2 slope, PETCO2 at rest, and PETCO2 at peak (r=0.414, p=0.006; r=-0.453, p=0.003; and r=-0.424, p=0.005, respectively).

Conclusion: The phase difference between PETCO₂ and VE is associated with the severity of heart failure and suggests that oscillatory breathing may be partly related to impaired PaCO₂ regulation in patients with cardiovascular diseases.

Introduction: Molecular genetic testing is increasingly offered to patients with dilated cardiomyopathy (DCM). The diagnosis of an inherited cardiomyopathy has major implications for medical care of patients and relatives. We report the results of a genotype-phenotype analysis of DCM investigated in Austria.

Methods: 194 patients with DCM underwent genetic testing over a period of 6 years. We analyzed the clinical and genetic characteristics of 105 DCM patients who showed a genetic variant, and compared the genetic findings and outcome measures of patients with inflammation on endomyocardial biopsy and those without.

Results: In 51.4% (54/105) patients at least one likely pathogenic or pathogenic genetic variant (LP/P) was detected. 51 of 105 patients (48.6%) showed only variants of unknown significance (VUS). Most LP/P variants (34,3%) were detected in the TTN gene. Clinical characteristics of the most prevalent genetic subgroups (TTN, LMNA, MYH7, MYH6, DMD, SCN5A) were not significantly different. DCM patients with inflammation had significantly higher frequency of memory of infection, left bundle branch block, mitral valve insufficiency, but normal CK-MB levels. We added a case report where two family members initially were considered to have an inflammatory cardiomyopathy before a pathogenic variant in LMNA was found.

Conclusion: Cardiac features of DCM were not predictive of a specific genetic subgroup. We recommend applying multigene panels extensively, since a large proportion of patients without a family history or evidence of inflammation showed a genetic predisposition for DCM. However, the large number of VUS remains a challenge.

The accepted manuscript "Cardiac Arrhythmias Associated with Brain Tumors: A Systematic Review" [Cardiology. 2025, https://doi.org/10.1159/000549272] by Darshan Hullon, Eesha Farhan, Fatima Hussain, Abiya Ahad, Mandana Akhavan, and Mahmoud H. Abouelsoud has been retracted.After peer review, the accepted, unedited manuscript was published online as Early View. Before the final Version of Record was published, errors in the following references were identified: 21, 28, 29, 32, 33, and 34.The authors stated that the errors in the references arose due to some fields being incorrectly transcribed. The Editor did not find that the concerns had been addressed satisfactorily and, as a consequence, rescinded the acceptance decision and rejected the manuscript. Consequently, the published author's accepted manuscript has been retracted. The authors disagree with the retraction.