Clinical Cardiology最新文献

{"title":"Short-Term, Mid-Term, and Long-Term Outcomes of Transcatheter Aortic Valve Replacement With Balloon-Expandable Versus Self-Expanding Valves: A Meta-Analysis of Randomized Controlled Trials","authors":"Kiarash Tavakoli,&nbsp;Negin Sadat Hosseini Mohammadi,&nbsp;Pegah Bahiraie,&nbsp;Sahar Saeidi,&nbsp;Farhad Shaker,&nbsp;Arman Soltani Moghadam,&nbsp;Sara Montazeri Namin,&nbsp;Habib Rahban,&nbsp;Shubhadarshini Pawar,&nbsp;Masih Tajdini,&nbsp;Hamidreza Soleimani,&nbsp;Yaser Jenab,&nbsp;Yousif Ahmad,&nbsp;Fady Hany Iskander,&nbsp;Mohamad Alkhouli,&nbsp;Raj Makkar,&nbsp;Aakriti Gupta,&nbsp;Kaveh Hosseini","doi":"10.1002/clc.70134","DOIUrl":"https://doi.org/10.1002/clc.70134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Comparisons of outcomes after transcatheter aortic valve replacement with balloon-expandable (BEV) versus self-expanding (SEV) valves are limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Hypothesis</h3>\u0000 \u0000 <p>This study aimed to compare clinical and hemodynamic outcomes of BEV and SEV at short-term (30 days), midterm (1 year), and long-term (&gt; 1 year) endpoints.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Embase, Scopus, and Cochrane Library databases were searched until July 2024 for randomized controlled trials. Random-effect model (DerSimonian–Laird method) was used to pool the risk ratios (RR), mean differences, and 95% confidence intervals (CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 10 studies comprising 4325 patients (2295 BEV, 2030 SEV) were included. In short-term, cardiovascular (RR: 0.56, 95% CI: 0.36–0.87) and all-cause mortality (RR: 0.54, 95% CI: 0.35–0.81) were lower in the BEV group. Risk of moderate to severe paravalvular leak (PVL) was lower among BEV patients in short-term (RR: 0.28, 95% CI: 0.17–0.49) and long-term (RR: 0.28, 95% CI: 0.1–0.79). A limited number of studies showed a greater risk of clinical valve thrombosis on BEV in midterm and long-term. The need for permanent pacemaker implantation was lower in BEV at both short-term (RR: 0.56, 95% CI: 0.37–0.87), and midterm (RR: 0.78, 95% CI: 0.64–0.94). The SEV group had a larger effective orifice area with lower mean transvalvular pressure gradient at all endpoints.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BEV is associated with reduced risk of clinical outcomes in short-term; however, most differences diminish in longer evaluations, except for moderate to severe PVL, which remains elevated for SEV. SEVs had better hemodynamic results and lower risk of clinical valve thrombosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849147","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":"Rising Mortality Related to Diabetes Mellitus and Hypertension: Trends and Disparities in the United States (1999−2023)","authors":"Shahnawaz Hashmi,&nbsp;Iqra Safdar,&nbsp;Muhammad Hazqeel Kazmi,&nbsp;Eeshal Zulfiqar,&nbsp;Maryam Shahzad,&nbsp;Sonia Hurjkaliani,&nbsp;Mennatalla Ayyad,&nbsp;Nimra Zuberi,&nbsp;Toqeer Ahmed,&nbsp;Gauri Balan Sujay,&nbsp;Hamid Talal,&nbsp;Syeda Hazqah Kazmi,&nbsp;Muhammad Farooq Khan,&nbsp;Gabriel Imbianozor,&nbsp;Mushood Ahmed,&nbsp;Raheel Ahmed","doi":"10.1002/clc.70132","DOIUrl":"https://doi.org/10.1002/clc.70132","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Individuals with diabetes mellitus (DM) are at an increased risk of vascular stiffness and atherosclerosis, which can predispose them to hypertension (HTN). Our study aims to analyze long-term mortality trends related to DM and HTN in the United States (US) and to identify vulnerable populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The CDC WONDER database was used to extract mortality data among adults (≥ 25 years of age) in the US who had concomitant DM and HTN. Age-adjusted mortality rates (AAMRs) were estimated and mortality trends were assessed using annual percentage change (APCs) with JoinPoint.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 2 769 118 deaths were attributed to DM and HTN in the US from 1999 to 2023. The AAMRs increased from 14.9 in 1999 to 66.8 in 2023 reflecting a 4.5-fold increase in mortality. A peak in mortality was observed during the COVID-19 pandemic with AAMR reaching 77.9 in with an APC of 15.7. Men had consistently higher AAMR compared to women (84.5 vs. 52.6 in 2023). Among racial/ethnic groups, non-Hispanic (NH) Black or African American individuals had the highest average AAMR, followed by Hispanic or Latino individuals, NH Other populations, and lastly the NH White individuals. The south had the highest AAMR among census regions and rural areas had higher mortality rates compared to urban areas (85.5 vs. 71.7).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study shows a 4.5-fold increase in DM and HTN-related mortality in the United States from 1999 to 2023. Demographic and geographical disparities were evident with men, NH Blacks or African Americans, and rural areas at the highest risk reflecting the need for improved healthcare.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835950","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":"How to Assess Risk Factors for Lead Dislodgement in Patients Receiving Cardiac Implantable Electronic Devices","authors":"Naoya Kataoka,&nbsp;Teruhiko Imamura","doi":"10.1002/clc.70131","DOIUrl":"https://doi.org/10.1002/clc.70131","url":null,"abstract":"<p>Based on the hypothesis that focal inflammation following cardiac implantable electronic device (CIED) implantation is pivotal in the development of adhesions between the lead and surrounding tissues, Matsuda et al. demonstrated a higher incidence of lead dislodgement in patients undergoing immunosuppressive therapy [<span>1</span>]. Several concerns have been raised regarding this finding.</p><p>The causality between immunosuppressive therapy and lead dislodgement remains questionable. The tip of a CIED lead typically elutes steroids to prevent an increase in the pacing threshold immediately postimplantation, thereby mitigating acute device-related inflammation. Consequently, focal inflammation is suppressed regardless of systemic immunosuppressant administration. Furthermore, many patients with cardiac sarcoidosis, who often require CIEDs and receive steroid therapy, do not exhibit a notably high incidence of lead dislodgement.</p><p>Alternative factors, such as frailty, might be implicated in lead dislodgement rather than steroid administration. Previous literature has identified frailty as an independent risk factor for lead dislodgement, potentially due to psychomotor agitation, inappropriate limb and chest movements, traumatic events, and progressive weight loss [<span>2</span>]. Long-term steroid therapy is generally associated with the progression of frailty [<span>3</span>]. Did the authors evaluate the severity of frailty in individuals receiving steroid therapy?</p><p>In a representative case of lead dislodgement presented in the authors' study, the lead appears to be pulled upwards, indicating insufficient pre-deflection at the time of implantation [<span>1</span>]. Variations in operator learning curves may have influenced clinical outcomes, including the incidence of lead dislodgement.</p><p>The authors have nothing to report.</p>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70131","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826902","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 Prevalence and Characteristics of Infective Endocarditis in Liver Transplant Recipients: Insights From National Inpatient Sample Database","authors":"Ajit Brar,&nbsp;Ayushi Garg,&nbsp;Isha Kohli,&nbsp;Soumiya Ravi,&nbsp;Carol Singh,&nbsp;Aalam Sohal,&nbsp;M Luay Alkotob","doi":"10.1002/clc.70130","DOIUrl":"https://doi.org/10.1002/clc.70130","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Liver transplant (LT) recipients are immunocompromised and thus predisposed to various bacterial and fungal infections, including infective endocarditis (IE). The current paper aims to determine the prevalence, characteristics, and outcomes of IE in LT recipients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The National Inpatient Sample (NIS) data from 2016 to 2020 was used to identify LT recipients. Patients were separated into two groups based on the presence of IE. Information was collected on patient demographics, hospital characteristics, infections, comorbidities, and outcomes. Multivariate logistic regression was performed to assess the impact of IE on outcomes after adjusting for confounding factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 170 650 patients who underwent LT were identified using NIS data from 2016 to 2020, of which 0.003% had IE. IE group had higher odds of in-hospital mortality [aOR 2.2 (95% CI 1.07–4.78)], Shock [aOR 2.7 (95% CI 1.61–4.65)], ICU admission [aOR 2.40 (95% CI 1.4–4.2)], longer Length of Stay [adj. Coeff- 3.4 days (95% CI −0.89–5.9, <i>p</i> &lt; 0.008)], and higher hospitalization charges (adj. coeff-$65271.52, 95% CI $14 825–$115 718) than LT without IE group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Staphylococcus was present in 18.6% of IE in LT, followed by enterococcus (12.8%) and gram-negative bacteria (9.8%). Concomitant IE was associated with increased in-hospital death, ICU stay, and shock. The IE group was also associated with increased LOS and total charges compared to the LT without IE. Although the prevalence of IE is low in LT recipients, its presence portends worse outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70130","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826903","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":"Evaluating the Lidocaine's Initial Dosing in Patients With Ventricular Arrhythmias and Heart Failure Admitted in Intensive Care Units","authors":"Kazuhiko Kido","doi":"10.1002/clc.70126","DOIUrl":"https://doi.org/10.1002/clc.70126","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Lidocaine is an antiarrhythmic with narrow therapeutic window indicated for refractory ventricular arrhythmia. Limited guidance is available regarding the initial infusion rate ranging from 1 to 4 mg/min in patients with heart failure (HF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The primary objective was to assess the optimal initial dosing of lidocaine therapy in patients with HF and ventricular arrhythmia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The retrospective cohort study was performed to include patients aged 18 years or older with past medical history of HF or new onset HF who developed ventricular arrythmia requiring lidocaine therapy in cardiovascular intensive care units. The primary outcome was lidocaine levels within the therapeutic ranges (defined as 1.5 to 5.0 μg/L). The study also described the predictive performance of lidocaine one compartment PK model using correlation efficient between the population PK model-predicted levels and observed levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 56 patients with HF and ventricular arrhythmia was included. The mean lidocaine maintenance dose was 1.1 ± 0.5 mg/min. The median (IQR) lidocaine level was 3.1 (2.3, 4.1) μg/L. The probabilities within therapeutic, supratherapeutic, and subtherapeutic ranges were 66.1%, 19.6%, and 14.3%, respectively in the whole cohort. Predicted lidocaine levels with one compartment PK model were not correlated with observed lidocaine levels (<i>R</i>² = 0.34). The simulation investigation showed that 1 mg/min rate achieved the highest probability within therapeutic range compared to 0.5, 1.5, and 2.0 mg/min rates (78.6 vs. 53.6, 53.6, and 28.6%, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Lidocaine initial infusion rate should be up to 1 mg/min in patients with HF and ventricular arrhythmia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770148","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":"RETRACTION: Vigorous Physical Activity and Atrial Fibrillation in Healthy Individuals: What Is the Correct Approach?","authors":"","doi":"10.1002/clc.70118","DOIUrl":"https://doi.org/10.1002/clc.70118","url":null,"abstract":"<p><b>RETRACTION</b>: G. Margolis, O. Cohen, and A. Roguin, ”Vigorous Physical Activity and Atrial Fibrillation in Healthy Individuals: What Is the Correct Approach?, ” <i>Clinical Cardiology</i> 47, no. 3 (2024): e24237, https://doi.org/10.1002/clc.24237.</p><p>The above article, published online on March 5, 2025 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, John Camm; Wiley Periodicals, LLC. The retraction has been agreed upon following an investigation into concerns raised by a third party, which revealed major textual overlap and data redundancy with multiple previously published review articles and protocols by independent groups of authors [<span>1-6</span>]. Although these articles are cited in the manuscript, the verbatim overlap is too substantial, and as a result, the editors consider this a redundant publication with incremental original content. The authors do not agree with the retraction.</p>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741632","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":"“Investigation of the Effect of Sleep Hygiene Training on Obstructive Sleep Apnea Symptoms, Fatigue, and Sleep Quality In Patients With Atrial Fibrillation”","authors":"Besey Ören,&nbsp;Busra Zehra Buyukkilic,&nbsp;Semiha Akin Eroglu,&nbsp;Ahmet Lutfullah Orhan","doi":"10.1002/clc.70128","DOIUrl":"https://doi.org/10.1002/clc.70128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Sleep hygiene education is widely used as a coping strategy for sleep disorders and is known to be an effective, and side-effect-free approach. To improve sleep quality by reducing the symptoms and fatigue level experienced by patients with OSAS with sleep hygiene education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The study was a single-center, randomized controlled research. A structured training program was applied face-to-face to the intervention group. Received inpatient treatment for atrial fibrillation in the Cardiology Service of a Training and Research Hospital between June 2023 and December 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant difference was found between the MOS Sleep Scale scores of the control group and the intervention group at 1 month in terms of sleep disturbance, sleep adequacy, shortness of breath, sleepiness, snoring, and sleep duration subscales. Fatigue, concentration, motivation, and physical activity scores of the intervention group patients were lower at the end of the 1st month.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Sleep hygiene education has a positive effect on sleep duration in patients with Atrial Fibrillation, however it is ineffective in ensuring high quality sleep.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70128","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741631","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":"Impact of Walking and Respiratory Training on Cardiopulmonary Function and Activity Endurance in Patients With Chronic Heart Failure","authors":"Qiu-Chen Wang,&nbsp;Jiang-Ying Li,&nbsp;Xiao-Su Ni,&nbsp;Wen-Wen Zhao,&nbsp;Xiao-Cui Wang,&nbsp;Li-Chun Wang","doi":"10.1002/clc.70123","DOIUrl":"https://doi.org/10.1002/clc.70123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to examine the impact of combining walking with respiratory training in patients with chronic heart failure (CHF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eighty patients with CHF, admitted to the Department of Cardiology at the Affiliated Taizhou People's Hospital of Nanjing Medical University between January 2024 and June 2024, were selected as study participants. They were randomly assigned to either a control group or an observation group, with 40 patients in each group. The control group received standard rehabilitation care, while the observation group underwent walking combined with respiratory training along with standard rehabilitation care. Cardiac function, pulmonary function, and activity tolerance were compared between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After 3 months of intervention, the observation group exhibited lower levels of heart rate (HR), left ventricular end-diastolic diameter (LVEDD), and left ventricular end-systolic diameter (LVESD) compared to the control group, while the left ventricular ejection fraction (LVEF) was significantly higher (<i>p</i> &lt; 0.05). Additionally, the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV₁), FEV₁/FVC ratio, and 6-min walking distance were greater in the observation group compared to the control group (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients with CHF, combining walking and respiratory training significantly enhances cardiopulmonary function and activity tolerance, demonstrating potential clinical use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741583","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":"Assessment of Risk Factors for Atrial Fibrillation With a Particular Focus on Echocardiographic Parameters, in Patients With Acute Myocardial Infarction","authors":"Beata Jacuś,&nbsp;Anna Milewska,&nbsp;Paweł Miękus,&nbsp;Marcin Konarzewski,&nbsp;Ludmiła Daniłowicz-Szymanowicz,&nbsp;Andrzej Lubiński,&nbsp;Grzegorz Grześk","doi":"10.1002/clc.70114","DOIUrl":"https://doi.org/10.1002/clc.70114","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atrial fibrillation is the most common arrhythmia worldwide, affecting between 2% and 4% of population. The projected further progression is a reason to consider AF as a global epidemic problem. The efficiency in diagnosing new cases is still unsatisfactory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The prospective study included 74 patients hospitalized for acute myocardial infarction. Echocardiography with advanced assessment of the left atrium was performed on all patients. R Statistical Software was used for statistical and graphical processing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Atrial fibrillation was first diagnosed in 13.5% of patients with acute myocardial infarction, and in 5.4% of the patients the diagnosis was made during the long-term follow-up period. Analysis of the data collected showed that patients with arrythmia were older (71.79 vs 63.5 years; <i>p</i> = 0.047), had a higher BMI (30.15 vs 26.76 kg/m²; <i>p</i> = 0.039) and had a higher CHA₂DS₂ VASc score (4.14 vs 3.02 points). Among the echocardiographic parameters, those that significantly differentiated patients with arrythmia included larger LA area (21.62 vs 18.84 cm²; <i>p</i> = 0.027), lower LAEF 4CH (43.46 vs 55.93%; <i>p</i> = 0.029), lower LAEF mean (44.08 vs 55.63%; <i>p</i> = 0.014), lower EI (1.03 vs 1.49; <i>p</i> = 0.032), lower LASr 4CH (19.08 vs 26.72%; <i>p</i> = 0.020), lower LASr mean (18.62 vs 26.73%; <i>p</i> = 0.009), higher E/e’ (12.62 vs 9.58; <i>p</i> = 0.01), higher LASI (0.95 vs 0.45; <i>p</i> = 0.016).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among the echocardiographic parameters, those that may indicate an increased risk of atrial fibrillation and could be implemented in clinical practice are LASr and LASI. Determining them in risk profiling and the implementation of individualized arrhythmia detection methods could increase diagnostic efficiency.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717214","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":"Predicting In-Hospital Mortality in Patients With Acute Myocardial Infarction: A Comparison of Machine Learning Approaches","authors":"Hamidreza Soleimani,&nbsp;Soroush Najdaghi,&nbsp;Delaram Narimani Davani,&nbsp;Parham Dastjerdi,&nbsp;Parham Samimisedeh,&nbsp;Hedieh Shayesteh,&nbsp;Babak Sattartabar,&nbsp;Farzad Masoudkabir,&nbsp;Haleh Ashraf,&nbsp;Mehdi Mehrani,&nbsp;Yaser Jenab,&nbsp;Kaveh Hosseini","doi":"10.1002/clc.70124","DOIUrl":"https://doi.org/10.1002/clc.70124","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acute myocardial infarction (AMI) remains a leading global cause of mortality. This study explores predictors of in-hospital mortality among AMI patients using advanced machine learning (ML) techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 7422 AMI patients treated with percutaneous coronary intervention (PCI) at Tehran Heart Center (2015–2021) were analyzed. Fifty-eight clinical, demographic, and laboratory variables were evaluated. Seven ML algorithms, including Random Forest (RF), logistic regression with LASSO, and XGBoost, were implemented. The data set was divided into training (70%) and testing (30%) subsets, with fivefold cross-validation. The class imbalance was addressed using the synthetic minority oversampling technique (SMOTE). Model predictions were interpreted using SHapley Additive exPlanations (SHAP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In-hospital mortality occurred in 129 patients (1.74%). RF achieved the highest predictive performance, with an area under the curve (AUC) of 0.924 (95% CI 0.893–0.954), followed by XGBoost (AUC 0.905) and logistic regression with LASSO (AUC 0.893). Sensitivity analysis in STEMI patients confirmed RF's robust performance (AUC 0.900). SHAP analysis identified key predictors, including lower left ventricular ejection fraction (LVEF; 33.24% vs. 43.46% in survivors, <i>p</i> &lt; 0.001), higher fasting blood glucose (190.38 vs. 132.29 mg/dL, <i>p</i> &lt; 0.001), elevated serum creatinine, advanced age (70.92 vs. 61.88 years, <i>p</i> &lt; 0.001), and lower LDL-C levels. Conversely, BMI showed no significant association (<i>p</i> = 0.456).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ML algorithms, particularly RF, effectively predict in-hospital mortality in AMI patients, highlighting critical predictors such as LVEF and biochemical markers. These insights offer valuable tools for enhancing clinical decision-making and improving patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707637","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}