Clinical Cardiology最新文献

{"title":"Explanatory Variables of Objectively Measured 24 h Movement Behaviors in Coronary Heart Disease Patients: A Systematic Review","authors":"Xiaofeng Peng, Ting Guo, Xiuzheng Wang, Yin Wan, Ying Peng, Ting Cheng, Siyue Tang, Hui Tu","doi":"10.1002/clc.70440","DOIUrl":"10.1002/clc.70440","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study systematically examined the multilevel determinants influencing 24 h movement behaviors (physical activity, sedentary behavior, and sleep) in coronary heart disease patients on the basis of a socioecological model. The aim was to provide evidence-based recommendations for behavior modification in coronary heart disease patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted this systematic review adhering to PRISMA 2020. Using the PICOS framework, we included observational studies of adults (≥ 18 years) with coronary heart disease, measuring 24 h movement behaviors (physical activity, sedentary behavior, sleep) objectively. Outcomes included behavioral time allocation and explanatory variables. We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library from inception to November 9, 2025. Data regarding study characteristics, behavioral measurement methods, and explanatory variables were independently extracted. Methodological quality was assessed using the Newcastle−Ottawa Scale for cohort studies and the Joanna Briggs Institute Critical Appraisal Checklist for cross-sectional studies. The socioecological model served as the analytical framework to organize extracted explanatory variables into four hierarchical levels: intrapersonal, interpersonal, environmental, and policy. This multilevel synthesis provided a systematic architecture for understanding behavioral heterogeneity, moving beyond the simplistic attribution of behaviors to individual physiology. Evidence synthesis and grading were performed using the method proposed by Sallis et al., which entailed calculating the proportion of studies supporting the hypothesized direction of association to evaluate the strength of evidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 24 studies were included, although none comprehensively explored 24 h movement behaviors in coronary heart disease patients. Only seven studies explored the determinants of two activity behaviors simultaneously, while the remaining 17 studies focused on isolated behaviors. The findings revealed that the primary explanatory variables were concentrated at the intrapersonal level, with aging significantly associated with reduced physical activity, while participation in cardiac rehabilitation was linked to increased physical activity. At the interpersonal level, social support moderated both physical activity levels and sedentary behavior. At the environmental level, residential characteristics were associated with 24 h movement behavior patterns; however, no significant associations were found at the policy level.</p>\u0000 ","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 8","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70440","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Mortality Related to Different Circulatory Diseases Before, During and After the COVID-19 Pandemic”","authors":"Abhinit Kumar, Ranjana Roy, Parappa Sajjan, Alok Bhatt, Jeffrin Reneus Paul","doi":"10.1002/clc.70449","DOIUrl":"https://doi.org/10.1002/clc.70449","url":null,"abstract":"<p>Capodaglio and colleagues [<span>1</span>] provide valuable population-level evidence using multiple causes of death (MCOD), seasonal autoregressive integrated moving average models, and Lee-Carter sensitivity analyses. Their conclusion that cardiovascular mortality in 2023 largely returned to pre-pandemic trends is plausible. However, the strength of that inference depends on two linked choices: how a cardiovascular-related death is defined and how the counterfactual trajectory is constructed.</p><p>Counting any mention of ischemic heart disease, cerebrovascular disease, hypertensive disease, or atrial fibrillation improves recognition of multimorbidity, but MCOD rates are also sensitive to death-certification and co-mention practices [<span>2</span>]. During and after COVID-19, changes in whether chronic cardiovascular disease is selected as the underlying cause, listed as a contributing condition, or co-recorded with COVID-19 could alter apparent trends without an equivalent change in disease incidence. A paired analysis of underlying-cause and MCOD rates, the annual MCOD-to-underlying-cause ratio, and the proportion of certificates with COVID-19 co-mentioned would help distinguish epidemiological recovery from certification effects. This matters because underlying-cause analyses have shown divergent 2023 patterns across cardiovascular subtypes [<span>3</span>].</p><p>The counterfactual is similarly consequential. The primary forecast uses the entire 2008-2019 period, although the pre-pandemic trajectories differ markedly among the four conditions and may not remain stable across alternative baseline windows. Methodological comparisons in the same regional setting have shown that excess-mortality estimates vary with the selected baseline and modeling approach [<span>4</span>]. Rolling-origin validation through 2019, forecasts based on shorter windows such as 2010−2019 and 2015−2019, and an ensemble or interrupted-time-series sensitivity analysis would quantify this dependence. Conversely, the 2008-2022 model includes the pandemic shock in its fitting period; therefore, observed 2023 rates below that forecast should not be treated as an independent confirmation of recovery. The most defensible wording is that 2023 rates were consistent with, rather than proved to have returned to, the pre-pandemic counterfactual.</p><p>Finally, the December 2023 peak is described as associated with simultaneous circulation of respiratory viruses. European surveillance documented temporal coincidence between excess mortality and COVID-19, influenza, and respiratory syncytial virus activity [<span>5</span>], but the present analysis did not directly test that attribution. Incorporating viral-surveillance indicators, temperature, and COVID-19 co-mention as exogenous covariates, ideally with age- and sex-stratified estimates, would clarify whether the late-2023 signal reflected infection, seasonality, or residual model error. These additions would not negate the","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 8","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70449","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148754072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic Urinary Albumin/Creatinine Ratio Patterns Predict Adverse Outcomes in HFpEF: TOPCAT Cohort Analysis","authors":"Weiping Xiao,&nbsp;Zhiyan Wang,&nbsp;Di-en Yan,&nbsp;Min-an Peng,&nbsp;Xinyuan Zhou","doi":"10.1002/clc.70446","DOIUrl":"https://doi.org/10.1002/clc.70446","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Urinary albumin-to-creatinine ratio (uACR) is a recognized cardiovascular risk marker, but its dynamic changes in heart failure with preserved ejection fraction (HFpEF) remain underexplored. We aimed to identify distinct uACR trajectory patterns and their associations with clinical outcomes in HFpEF patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed 746 HFpEF patients with ≥ 3 uACR measurements from the TOPCAT trial. Latent Class Trajectory Modeling identified uACR patterns. The primary outcome was cardiovascular death, aborted cardiac arrest, or heart failure hospitalization. Cox proportional hazards models assessed associations between trajectories and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three uACR trajectory patterns emerged: stable (70.5%), decreasing (16.5%), and fluctuating high (13.0%). The primary endpoint occurred in 15.02%, 25.20%, and 36.08% of patients, respectively (<i>p</i> &lt; 0.001). In adjusted models, the fluctuating high group showed increased risk for the composite endpoint (HR 1.91, 95% CI 1.25–2.91) and heart failure hospitalization (HR 1.91, 95% CI 1.19–3.06), while the decreasing group showed an association with myocardial infarction based on few events (HR 3.00, 95% CI 1.33–6.76). Adding trajectory information produced a modest improvement in risk prediction (C-index 0.758 to 0.765; AUC 0.786 to 0.792 at 4 years and 0.832 to 0.845 at 6 years, <i>p</i> = 0.0149).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study first identified distinct uACR trajectory patterns in HFpEF patients. The fluctuating high trajectory was associated with increased cardiovascular risk and heart failure hospitalization, while the association between the decreasing trajectory and myocardial infarction was exploratory and requires validation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 8","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70446","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148753756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal Trends in Mortality Due to Ischemic Heart Disease and Cardiac Arrhythmias in the United States From 1999 to 2023","authors":"Taha Alam,&nbsp;Sohaima Kamal,&nbsp;Dhvanit Rajdeep,&nbsp;F. N. U. Areesha,&nbsp;Pardeep Kumar,&nbsp;Hamza Yousuf Ibrahim,&nbsp;Muhammad Suleman Khan,&nbsp;Muhammad Ibrahim Rashid,&nbsp;Alisha Ahmed,&nbsp;Muhammad Raafay Jamil,&nbsp;Nicholas Aderinto,&nbsp;Ehsanullah Alokozay,&nbsp;Caleb Karani,&nbsp;Hassaan Abid","doi":"10.1002/clc.70450","DOIUrl":"https://doi.org/10.1002/clc.70450","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ischemic heart disease (IHD) remains a leading cause of mortality in the United States, while arrhythmia-related deaths are increasing. However, long-term mortality trends involving both conditions remain unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We utilized the CDC WONDER Multiple Cause-of-Death database to obtain records from 1999 to 2023, targeting US adults aged ≥ 25 years. Deaths involving IHD and arrhythmias were assessed. Age-adjusted mortality rates (AAMR) were calculated and stratified by gender, age, ethnicity, census region, and urbanization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1 795 918 deaths were attributed to both IHD and cardiac arrhythmias between 1999 and 2023. The AAMR declined from 41.97 (95% CI: 41.66−42.27) in 1999 to 32.73 (95% CI: 32.51−32.94) in 2023, representing an overall decrease of 22% (AAPC −0.99). Men had higher AAMRs compared to women (45.0 [95% CI: 44.6−45.5] vs. 23.4 [95% CI: 23.2−23.7]). The highest mortality rate was observed among NH White individuals (AAMR: 34.8; 95% CI: 34.5−35.0), while the lowest was among NH Asian or Pacific Islanders (AAMR: 16.5; 95% CI: 15.6−17.5). Older adults exhibited the higher AAMRs (144.74; 95% CI: 143.60−145.88) compared to younger cohorts. An increased death burden was observed in non-metropolitan (AAMR: 37.1; 95% CI: 36.5−37.8) and Midwest regions (35.5; 95% CI: 34.9−36.0). The majority of the deaths occurred in inpatient facilities (34.7%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although IHD–arrhythmia mortality declined between 1999 and 2023, substantial disparities persisted across demographic and geographic subgroups, highlighting the need for targeted public health interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 8","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70450","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148754173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Albumin Modifies the Prognostic Meaning of BNP in Acute Decompensated Heart Failure","authors":"Muneera O. AlTaweel,&nbsp;Elbadri I. Abdelgadir,&nbsp;Lulwah Al Turki,&nbsp;Ramy I. Abulikailik,&nbsp;Fahad Alharbi,&nbsp;Khamess O. Khamees,&nbsp;Waleed Gado","doi":"10.1002/clc.70445","DOIUrl":"10.1002/clc.70445","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>BNP is widely used for risk stratification in acute decompensated heart failure (ADHF), but its prognostic meaning may differ across clinical phenotypes, particularly cardiorenal syndrome type 1 (CRS1).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Hypothesis</h3>\u0000 \u0000 <p>We hypothesized that serum albumin modifies the association between BNP and adverse in-hospital course in ADHF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective cohort study, adults hospitalized with ADHF were classified as CRS1 or control. The primary endpoint was adverse in-hospital course, defined as in-hospital death and/or prolonged length of stay (≥ 75th percentile). BNP was analyzed on the natural log scale. Multivariable logistic regression included albumin, ln(BNP), and an albumin × ln(BNP) interaction term, adjusted for age, sex, systolic blood pressure, eGFR, ejection fraction, CRS status, body mass index, and diabetes mellitus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the complete-case cohort (<i>N</i> = 292; events = 77), albumin significantly modified the BNP-risk association (interaction <i>β</i> = −0.236 per 5 g/L; Wald <i>p</i> = 0.045; likelihood-ratio test <i>p</i> = 0.050). The adjusted odds ratio for a 1-unit increase in ln(BNP) was 1.81 at albumin 30 g/L, 1.42 at 35 g/L, and 1.12 at 40 g/L. Discrimination improved modestly with the interaction (AUC 0.714 vs. 0.726), and the high-BNP/low-albumin stratum showed the highest observed event risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Serum albumin modifies the prognostic meaning of BNP in ADHF. Integrating albumin into BNP interpretation identifies a high-risk “congestion plus vulnerability” phenotype and may support pragmatic triage and discharge planning in CRS-enriched ADHF populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 8","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70445","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Disease (CVD) Risk in Women With Endometriosis: A Comprehensive Meta-Analysis","authors":"Maneeth Mylavarapu,&nbsp;Jeffry Samuel,&nbsp;Ravitej Thandi,&nbsp;Rizwan Mubashir,&nbsp;Vaishnavi Reddy Veeranagari,&nbsp;Aly Barakat,&nbsp;Joao Ferreira de Barros Neto,&nbsp;Alaa Osman,&nbsp;Sudeeshna Thiyagarajan,&nbsp;Reem Mohamed,&nbsp;Muhammad Junaid Hassan","doi":"10.1002/clc.70443","DOIUrl":"10.1002/clc.70443","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cardiovascular disease (CVD) remains the leading cause of mortality globally. Emerging evidence indicates that cardiovascular risk in women is frequently underestimated, underscoring the importance of recognizing sex-specific contributors. Endometriosis is a chronic inflammatory disorder affecting 5%−10% of reproductive-aged women. However, previous syntheses evaluating its cardiovascular implications have yielded inconsistent results or were narrow in scope.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic literature search was conducted across databases, adhering to PRISMA guidelines. Studies comparing cardiovascular outcomes in women with versus without endometriosis were included. Primary outcomes were overall CVD and major adverse cardiovascular events (MACE). Secondary outcomes included ischemic heart disease (IHD), coronary artery disease (CAD), heart failure (HF), arrhythmias, coronary revascularization, and a composite of angina/acute myocardial infarction (Angina-AMI). Random-effects models with inverse variance weighting were used to calculate risk ratios (RRs) and 95% confidence intervals (CIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Women with endometriosis exhibited a significantly higher risk of primary outcomes, including overall CVD (RR 1.21; 95% CI 1.09–1.35; <i>p</i> = 0.004) and MACE (RR 1.23; 95% CI 1.10–1.38; <i>p</i> = 0.01). Regarding secondary outcomes, endometriosis was significantly associated with elevated risks of IHD (RR 1.57; 95% CI 1.14–2.17; <i>p</i> = 0.01), CAD (RR 1.36; 95% CI 1.32–1.41; <i>p</i> &lt; 0.0001), and Angina-AMI (RR 1.62; 95% CI 1.18–2.21; <i>p</i> = 0.002). Moderate-to-high statistical heterogeneity was observed across most secondary endpoints, except for CAD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Endometriosis is significantly associated with an increased risk of overall CVD, MACE, and ischemic coronary complications. These findings suggest that endometriosis should be recognized as an important sex-specific modifier of cardiovascular risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 8","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70443","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Superior Cardiorenal Protection With Tirzepatide Over Dulaglutide in Heart Failure With Preserved Ejection Fraction: A Large-Scale Propensity Score–Matched Real-World Analysis","authors":"Ibrahim Khalil,&nbsp;Md. Imran Hossain,&nbsp;Mst. Mahmuda Akter,&nbsp;Ferdous Wahid,&nbsp;Aizaz Anwar Khalid,&nbsp;Sunjida Amin Promi,&nbsp;Md. Abu Sayed,&nbsp;Mohd Turzo Rahman,&nbsp;Pallab Sarker","doi":"10.1002/clc.70441","DOIUrl":"10.1002/clc.70441","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>No direct head-to-head trials compare tirzepatide and dulaglutide in heart failure with preserved ejection fraction (HFpEF), though tirzepatide shows superior weight loss and potential cardiovascular benefits in recent trials like SURPASS-CVOT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective, propensity score-matched cohort study used de-identified electronic health records from the TriNetX US Collaborative Network (as of December 2025). Adults ≥ 18 years with HFpEF (ICD-10: I50.3) initiating tirzepatide (<i>n</i> = 35 174) or dulaglutide (<i>n</i> = 52 999), without prior exposure to the comparator, were identified. One-to-one greedy nearest-neighbor matching (caliper 0.1) on demographics, comorbidities, medications, and laboratory/echocardiographic data produced balanced cohorts of 24 305 patients each. Kaplan–Meier and Cox proportional hazards models evaluated 1-year and 3-year risks of all-cause mortality, acute heart failure events, all-cause hospitalization, myocardial infarction, stroke, atrial fibrillation, MACE, MAKE, acute pancreatitis, and hypoglycemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Post-matching, cohorts were well-balanced. Tirzepatide linked to lower 1-year risks of all-cause mortality (HR: 0.66, 95% CI: [0.59–0.74]), all-cause hospitalization (HR: 0.85, 95% CI: [0.82–0.88]), stroke (HR: 0.92, 95% CI: [0.87–0.97]), MACE (HR: 0.89, 95% [CI: 0.84–0.93]), MAKE (HR: 0.85, 95% CI: [0.79–0.91]), and acute pancreatitis (HR: 0.78, 95% CI: [0.63–0.96]). Benefits amplified at 3 years, especially mortality (HR: 0.60, [0.55–0.65]). Tirzepatide showed slightly higher 1-year atrial fibrillation risk (HR: 1.04, [1.00–1.07]). No differences in myocardial infarction or hypoglycemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this large real-world propensity-matched analysis, tirzepatide demonstrated superior reductions in mortality, hospitalizations, and cardiorenal outcomes versus dulaglutide in HFpEF patients, with a favorable safety profile.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 8","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “The Association of Hypertension Based on Systolic and Diastolic Blood Pressure With Dental Visits in the Population Aged 45 and Older: Cross-Section Study Results From the China Health and Retirement Longitudinal Study”","authors":"Zhe Zhang,&nbsp;Dong Cai,&nbsp;Suhua Xu","doi":"10.1002/clc.70442","DOIUrl":"10.1002/clc.70442","url":null,"abstract":"&lt;p&gt;We read with interest the study by Ao et al., which examined the associations of systolic and diastolic blood pressure and hypertension status with dental visits among Chinese adults aged 45 years and older [&lt;span&gt;1&lt;/span&gt;]. By analyzing measured blood pressure together with questionnaire data from the China Health and Retirement Longitudinal Study, the authors provide useful population-based evidence on patterns of dental attendance among middle-aged and older adults. However, one interpretive issue warrants clarification: the manuscript alternately describes the measured outcome as dental visits, oral disease, and oral health issues, although these terms do not represent the same construct.&lt;/p&gt;&lt;p&gt;The outcome was determined by whether participants had visited a dentist during the previous year for dental care, including dentures. The proportions reporting dental visits were 79.82%, 82.05%, and 84.25% in the normal blood pressure, prehypertension, and hypertension groups, respectively. In the fully adjusted model, hypertension was associated with dental attendance with an odds ratio of 1.30 (95% confidence interval, 1.06–1.60) [&lt;span&gt;1&lt;/span&gt;]. These findings quantify differences in dental attendance, but they do not provide corresponding estimates of the prevalence or severity of oral disease.&lt;/p&gt;&lt;p&gt;Importantly, this issue is not merely a limitation of self-reported measurement. It reflects a difference in the underlying construct being assessed. Dental attendance measures dental healthcare utilization, whereas oral disease burden concerns the presence and severity of conditions such as dental caries, periodontal disease, and tooth loss. Dental visits may be driven by oral symptoms, but they may also reflect preventive examinations, restorative treatment, denture maintenance, healthcare access, or greater health awareness. Therefore, a higher probability of dental attendance among individuals with hypertension does not necessarily indicate a greater burden of oral disease. Establishing such a conclusion would require disease-specific indicators, including standardized oral examinations, periodontal probing depth, clinical attachment loss, or tooth-loss measures [&lt;span&gt;2, 3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;We suggest that the authors consistently describe the outcome as dental visits or dental healthcare utilization throughout the abstract, results, discussion, and conclusion. It would also be helpful to clarify that dental attendance cannot serve as a direct surrogate for clinically assessed oral disease. If information on the reasons for attendance is available, distinguishing preventive, symptom-driven, restorative, and denture-related visits may further improve interpretation.&lt;/p&gt;&lt;p&gt;This clarification would not diminish the value of the study. Rather, it would more accurately define the scope of the findings and provide a clearer basis for future research that combines dental healthcare utilization data with clinical oral assessments to examine the relation","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 8","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13449293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Feasibility Assessment of Measuring Acceptance and Adherence to a Plant-Based (Vegan) Diet in a Cardiology Clinic","authors":"L. Smillie,&nbsp;M. Minehan,&nbsp;C. R. Knight-Agarwal,&nbsp;Ahmad Farshid","doi":"10.1002/clc.70438","DOIUrl":"10.1002/clc.70438","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Plant-based vegan diets (PBVDs) improve cardiometabolic risk markers, hence are recommended as an adjunct treatment by some cardiologists. To complete a service evaluation, practical measures of dietary adherence are required, and perceptions of patients need to be considered.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single-arm, mixed-methods design was used to assess the feasibility of using two diet indices to assess adherence to a PBVD and the acceptability of adopting a PBVD in a cardiac outpatient setting. Diet adherence was measured via absence of proscribed foods (APF) and a plant-based vegan diet score (PBVD-S). Acceptability of the PBVD was assessed via individual interviews and a food acceptability questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty patients completed the dietary assessment. After 8 weeks, 55% (<i>n</i> = 11) were classified as fully adherent to the PBVD. Mean score for the PBVD-S increased from 20.3 ± 8.7 at baseline to 38.9 ± 5.8 at Week 8. Mean total cholesterol (TC), body mass index (BMI), body mass, and waist circumference significantly decreased (<i>p</i> &lt; 0.001) after 8 weeks on the PBVD. The PBVD-S satisfied the feasibility criteria of alignment with diet education and assessment of adherence. The PBVD was rated as either “moderately” or “extremely” acceptable by 80% of patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The PBVD-S is a feasible option for assessing adherence and diet quality of a PBVD in a cardiology outpatient setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 8","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13449299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association between Hypoperfused Myocardium and Systolic Function in Patients With AMI Undergoing Complete Revascularization","authors":"Jin Si,&nbsp;Chong Zheng,&nbsp;Jinghao Sun,&nbsp;Keling Xiao,&nbsp;Yadong Cui,&nbsp;Bixiao Cui,&nbsp;Ming Yi,&nbsp;Lijie Sun,&nbsp;Haoyu Zhang,&nbsp;Shanshan Gu,&nbsp;Jie Lu,&nbsp;Jing Li","doi":"10.1002/clc.70437","DOIUrl":"10.1002/clc.70437","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Timely restoring coronary blood flow reduces mortality in acute myocardial infarction (AMI), while epicardial flow restoration is non-parallel to myocardial reperfusion. This prospective study examined temporal changes in myocardial perfusion and their association with left ventricular (LV) systolic function after complete revascularization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>AMI patients treated with complete revascularization underwent hybrid positron emission tomography/magnetic resonance imaging (PET/MR) at 2 months and 1 year after the index procedure. Hypoperfused myocardium was defined as reduced perfusion with preserved metabolism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-five patients (60.42 ± 11.47 years, 80.0% male) were enrolled, and hypoperfused myocardium (median: 12% of LV) was detected in 25 (45.5%) patients 2 months post-AMI. Patients with and without hypoperfused myocardium were classified as Group A and Group B, respectively. Higher high-sensitivity C-reactive protein (hs-CRP) and lower T2 values were observed in Group A and independently predicted baseline hypoperfused myocardium. At 1-year PET/MR follow-up, six (31.6%) patients in Group A showed perfusion recovery; these patients were more frequently female (<i>p</i> = 0.025), less frequently diabetic (<i>p</i> = 0.044) or overweight (<i>p</i> = 0.035), and had better baseline global longitudinal strain (GLS) (<i>p</i> = 0.005). Significant LV ejection fraction improvement was observed in Group A (56.39% ± 9.76% vs. 54.58% ± 10.39%, <i>p</i> = 0.016) but not in Group B (51.63% ± 13.09% vs. 50.79% ± 16.95%, <i>p</i> = 0.615).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Even after complete revascularization, myocardial hypoperfusion may persistently exist and evolve over time in AMI patients. The reversal of myocardial hypoperfusion is possibly associated with improved LV systolic function.</p>\u0000 \u0000 <p><b>Trial Registration:</b> The study was retrospectively registered on 2022-11-24 under the name Evaluation of short—and long-term cardiac structure and function in patients with acute coronary syndrome and made publicly available in the China Medical Research Registration Information System (https://www.medicalresearch.org.cn/), with the registration number MR.-11-23-000090.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 8","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13446020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}