Clinical Research in Cardiology最新文献

{"title":"Beyond the protocol: adherence to ECPR selection criteria and outcomes after Out-of-Hospital Cardiac Arrest (OHCA)-insights from the German Cardiac Arrest Registry (G-CAR).","authors":"A Springer, M Rossberg, C Sinning, I Voigt, A Freund, N Hösler, G Michels, S Ewen, F Voss, P Wohlmuth, H Thiele, U Zeymer, J Pöss, E Tigges","doi":"10.1007/s00392-026-02930-6","DOIUrl":"https://doi.org/10.1007/s00392-026-02930-6","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal cardiopulmonary resuscitation (ECPR) is a potential treatment for selected patients with refractory out-of-hospital cardiac arrest (OHCA). Randomized controlled trials (RCTs) emphasize the importance of appropriate patient selection. Expert consensus statements recommend six criteria for ECPR suitability: age ≤ 75 years, witnessed OHCA, bystander cardiopulmonary resuscitation (CPR), no-flow time ≤ 5 min (min), low-flow time ≤ 60 min, and an initial shockable rhythm. Although widely accepted, these items are not supported by robust data and adherence varies greatly. We present an analysis from the German Cardiac Arrest Registry (G-CAR) describing the current state of ECPR across participating centers.</p><p><strong>Results: </strong>Of 1,644 patients in G-CAR, 576 patients (34.6%) were admitted with ongoing CPR. Of these, 162 (28.0%) were treated with ECPR. Only 18 patients (11.0%) met all six ECPR criteria, with the majority displaying five (37.0%) or four (25.9%) characteristics. Overall, rates of favorable neurological survival at 30 days did not differ between patients treated with ECPR and those treated conventionally (8.6% vs. 5.6%, p = 0.25). When stratified according to the number of criteria, the probability of survival was higher in patients meeting all six or five compared to those meeting one to four criteria (20.0% vs. 11.9% vs. 1.4%; p = 0.028). A similar gradient in survival according to the number of fulfilled criteria was observed in conventionally treated patients.</p><p><strong>Conclusions: </strong>Adherence to proposed ECPR selection criteria was low in this real-world cohort, potentially contributing to lower survival rates compared with results from RCTs. However, when all criteria were fulfilled, survival rates were significantly higher, underscoring the importance of stringent patient selection.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834503","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":"Impact of angiographic valve expansion on the hemodynamic outcome in valve-in-valve transcatheter aortic valve replacement.","authors":"Christoph Höfer, Tau Hartikainen, Maria Lauber, Thomas Maulhardt, Vera Oettinger, Philipp Albrecht, Alexander Maier, Uwe Zeymer, Markus Jäckel, Dirk Westermann, Constantin von Zur Mühlen, Jonathan Rilinger","doi":"10.1007/s00392-026-02931-5","DOIUrl":"https://doi.org/10.1007/s00392-026-02931-5","url":null,"abstract":"<p><strong>Background: </strong>The durability of surgical aortic valve replacement prostheses can be limited due to structural valve deterioration over the years. Because of increased patient age and surgical risk, many of these patients are treated with valve-in-valve transcatheter aortic valve replacement (TAVR). Full expansion of the valve is often difficult to achieve in these patients, which might negatively affect the hemodynamic outcome.</p><p><strong>Aim: </strong>The aim was to investigate whether incomplete expansion of valve-in-valve TAVR correlates with an unfavorable hemodynamic outcome.</p><p><strong>Methods: </strong>A retrospective monocentric study with 152 patients who received a valve-in-valve TAVR between 2014 and 2024 at the University Heart Centre Freiburg-Bad Krozingen, Germany, was performed. The expansion and implantation depth of the TAVR prostheses were measured in the angiographic recordings and correlated with the postinterventional hemodynamic outcome.</p><p><strong>Results: </strong>69.7% of the patients received self-expanding and 28.9% balloon-expandable TAVR prostheses during the valve-in-valve procedure. Under-expansion in the waist area of self-expanding valve prosthesis was associated with increased postinterventional mean pressure gradients. Post-dilation significantly improved the waist expansion in self-expanding valve prostheses (median increase 7.8%, p < 0.0001). Further, a correlation between implantation depth and waist expansion was observed in self-expanding valves (Spearman r - 0.4481, p < 0.0001), but not in balloon-expandable valves.</p><p><strong>Conclusion: </strong>Under-expansion of the waist area of self-expanding valve-in-valve TAVR was associated with an unfavorable hemodynamic outcome. A periinterventional measurement of the angiographic images after valve release might be useful to assess a relevant under-expansion and to assist in the indication for post-dilation.</p><p><strong>Clinical trials register: </strong>The study has been registered in the German Clinical Trials Register (DRKS-ID: DRKS00029242), date: 27/03/2023.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811720","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":"Shock index and modified shock index at discharge as predictors of long-term mortality after myocardial infarction: results from the Augsburg Myocardial Infarction Registry.","authors":"Constantin Rödl, Christa Meisinger, Bernhard Kuch, Philip Raake, Jakob Linseisen, Timo Schmitz","doi":"10.1007/s00392-026-02929-z","DOIUrl":"https://doi.org/10.1007/s00392-026-02929-z","url":null,"abstract":"<p><strong>Background: </strong>Shock index (SI) and modified shock index (mSI), measured at hospital admission, have been shown to be predictive for mid- and long-term outcomes after acute myocardial infarction (AMI). Whether these associations also hold when indices are measured at discharge is unclear, so this study's aim was to analyze the association between SI and mSI at discharge and long-term mortality after AMI.</p><p><strong>Material and methods: </strong>This analysis included 11,676 AMI cases registered by the population-based Myocardial Infarction Registry Augsburg. The follow-up time was restricted to a maximum of 5 years. Patients were categorized into low and high SI or mSI groups through separation at 75th percentiles for STEMI and NSTEMI, respectively. Analysis of survival included Kaplan-Meier curves with log-rank tests and multivariable-adjusted Cox-regression models.</p><p><strong>Results: </strong>Cut-off values were 0.6667 (STEMI) and 0.6545 (NSTEMI) for SI and 0.9231 (STEMI) and 0.9120 (NSTEMI) for mSI. Kaplan-Meier analysis showed significantly higher mortality for high SI and mSI groups in STEMI and NSTEMI patients. In STEMI cases, multivariable-adjusted Cox-regression analyses revealed significantly higher mortality for the high SI group (hazard ratio (HR): 1.25 (1.02-1.53), p value: 0.030), while mSI was non-significantly associated with long-term mortality (HR: 1.21 (0.99-1.48), p value: 0.060). Neither SI nor mSI was independently associated with mortality in NSTEMI.</p><p><strong>Conclusion: </strong>SI and mSI at discharge represent valuable tools for long-term post-infarction risk stratification especially in STEMI cases and can support decision-making regarding individualized ambulatory care.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811793","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":"Incidence and recurrence of atrial fibrillation among patients with obstructive hypertrophic cardiomyopathy treated with mavacamten: a single-center experience.","authors":"Lusha W Liang, Heidi S Lumish, Yuichi J Shimada, Shepard D Weiner","doi":"10.1007/s00392-024-02496-1","DOIUrl":"10.1007/s00392-024-02496-1","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"887-891"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141854955","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":"Causal atlas on comorbidities in cardiomyopathy: a Mendelian randomization study of European ancestry.","authors":"Mengting Sun, Ming Gao, Peng Huang, Manjun Luo, Tingting Wang, Xiaorui Ruan, Kebin Chen, Jiapeng Tang, Ye Chen, Jiabi Qin","doi":"10.1007/s00392-025-02647-y","DOIUrl":"10.1007/s00392-025-02647-y","url":null,"abstract":"<p><strong>Background: </strong>Cardiomyopathy (CM) is often accompanied by comorbidities that increase the risk of death. Our aim is to explore the causal association between CM and its subtypes and various related comorbidities.</p><p><strong>Methods: </strong>Bidirectional Mendelian randomization (MR) was used to explore the causal association between 39 comorbidities and CM, 13 comorbidities and hypertrophic cardiomyopathy (HCM), 25 comorbidities and dilated cardiomyopathy (DCM), and 13 comorbidities and restrictive cardiomyopathy (RCM). Besides, we explored the causal associations between systolic, diastolic, and pulse pressure with CM and DCM, respectively. MR Mediation analysis was used to explore whether atrial fibrillation (AF) or hypertension was as mediating variable mediating the causal association between each other and CM.</p><p><strong>Results: </strong>By MR analysis, we found that AF (OR = 1.28) and hypertension (OR = 3.58) were associated with an increased risk of CM, and CM was causally associated with an increased risk of heart failure (OR = 1.40). In addition, hypertension was causally associated with a lower risk of DCM (OR = 0.22). The results of the causal association of systolic, diastolic, and pulse pressure with CM and DCM were consistent with the direction of the causal association of hypertension with CM and DCM. Through MR Mediation analysis, we found AF as a mediating factor mediates the causal association between hypertension and CM, with a mediating proportion of about 16.22%.</p><p><strong>Conclusions: </strong>This study is the first to reveal the causal association between certain comorbidities and CM and DCM, and to find possible mediating effects among them.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"763-773"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981222","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":"Non-specific myocardial fibrosis in young competitive athletes: clinical significance and risk prediction by a powerful machine learning-based model.","authors":"E Androulakis, S Marwaha, N Dikaros, R Bhatia, H MacLachlan, S Fyazz, N Chatrath, A Merghani, G Finocchiaro, S Sharma, M Papadakis","doi":"10.1007/s00392-024-02550-y","DOIUrl":"10.1007/s00392-024-02550-y","url":null,"abstract":"<p><strong>Background: </strong>Non-specific myocardial fibrosis (NSMF) is a heterogeneous entity. We aimed to evaluate young athletes with and without NSMF to establish potentially clinically significance.</p><p><strong>Methods: </strong>We analysed data from 328 young athletes. We identified 61 with NSMF and compared them with 75 matched controls. Athletes with NSMF were divided into Group 1 (n = 28) with 'minor' fibrosis and Group 2 (n = 33) with non-insertion point fibrosis, defined as 'major'. Athletes were followed-up for adverse events. Finally, we tested various machine learning (ML) algorithms to create a prediction model for 'major' fibrosis. We created 4 different classifiers.</p><p><strong>Results: </strong>Athletes of black ethnicity were more likely to have a subepicardial pattern (OR: 5.0, p = 0.004). Athletes with 'major' fibrosis demonstrated a higher prevalence of lateral T-wave inversion (TWI) ( < 0.001) and ventricular arrhythmias (VEs > 500/24 h, p = 0.046; non-sustained VT, p = 0.043). Athletes with 'minor' fibrosis demonstrated higher right ventricular volumes (p = 0.013), maximum Watts (p = 0.022) and maximum VO₂ (p = 0.005). Lateral TWI (p = 0.026) and VO₂ < 44 mL/min/Kg (p = 0.040) remained the only significant predictors for 'major' fibrosis. During follow up, athletes with 'major' fibrosis were 9.1 times more likely to exhibit adverse events (OR 13.4, p = 0.041). All ML models outperformed the benchmark method in predicting significant MF, best accuracy achieved by the random forest classifier (90%).</p><p><strong>Conclusions: </strong>Lateral TWI and reduced exercise performance are associated with higher burden of fibrosis. Fibrosis was associated with increased ventricular arrhythmia and adverse events. A comprehensive assessment can help develop a ML-based model for significant fibrosis, which could also guide clinical practice and appropriate CMR referrals.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"732-742"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459737","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":"Left ventriculo-arterial coupling in a contemporary cohort of patients with wild-type transthyretin cardiac amyloidosis treated with tafamidis.","authors":"Giuseppe Damiano Sanna, Valeria Anna Di Simone, Paolo Milani, Alessandro Fogliani, Roberta Mussinelli, Gianluigi Guida, Andrea Attanasio, Laura Obici, Marco Basset, Martina Nanci, Andrea Foli, Gavino Casu, Leonardo De Luca, Mario Nuvolone, Giampaolo Merlini, Stefano Perlini, Giovanni Palladini","doi":"10.1007/s00392-025-02727-z","DOIUrl":"10.1007/s00392-025-02727-z","url":null,"abstract":"<p><strong>Background: </strong>Wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) is characterized by a labile equilibrium between preload and afterload. A tailored approach to supporting medical therapy based on noninvasive parameters able to describe the properties of both heart and systemic vasculature, and their interactions is required. However, data on ventriculo-arterial coupling (VAC) in ATTRwt-CM is lacking.</p><p><strong>Objectives: </strong>To describe ventriculo-arterial coupling (VAC) and its clinical correlates in a contemporary cohort of patients with ATTRwt-CM.</p><p><strong>Methods: </strong>The VAC, defined as the ratio between arterial (E_a) and ventricular elastance (E_es) was evaluated noninvasively using the single-beat algorithm based on arm cuff blood pressure, Doppler stroke volume, pre-ejection time and total ejection time.</p><p><strong>Results: </strong>The study included 114 patients treated with the transthyretin stabilizer tafamidis from a national referral centre (median age 79 years; 89% males). Median values were 1.48 (1.22-1.84) mmHg/ml for E_a, 1.86 (1.49-2.29) mmHg/ml for E_es, and 1.24 (0.96-1.58) for VAC. Patients with upper-tertile VAC showed worse clinical (National Amyloidosis Centre (NAC)/Mondor stage, p < 0.001), laboratory (NT-pro-B-type natriuretic peptide levels, p < 0.001), instrumental features (left ventricular ejection fraction and stroke volume, p = 0.0001 for both), and they received more intensive heart failure supportive therapies. The E_a/E_es ratio, but not its single components, was associated with NT-proBNP levels. Finally, the E_a/E_es ratio was an independent determinant of a high NAC/Mondor stage at both univariate (OR[95% CI]:15.39[3.51-67.35], p < 0.001) and multivariate (OR[95% CI]:11.26[1.98-63.81], p = 0.006) logistic regression analyses.</p><p><strong>Conclusion: </strong>In ATTRwt-CM patients, arterial and ventricular elastances and VAC are independent predictors of worse clinical status and more advanced disease stage.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"811-825"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13083476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tachycardia-induced cardiomyopathy in de novo heart failure: prevalence, short-term outcomes, and the role of guideline-directed therapy in ejection fraction improvement.","authors":"Alberto Esteban-Fernández, Inés Gómez-Otero, Silvia López-Fernández, Raquel López-Vilella, Francisco Pastor-Pérez, Óscar Otero-García, Miguel Rodríguez-Santamarta, David García-Vega, Paula Fluvià, Víctor Donoso-Trenado, Ester Sánchez-Corral, José Manuel García-Pinilla, Juan Luis Bonilla-Palomas, Andrea López López, José Ramón González-Juanatey, Luis Almenar Bonet","doi":"10.1007/s00392-025-02663-y","DOIUrl":"10.1007/s00392-025-02663-y","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure (HF) secondary to tachycardia-induced cardiomyopathy (TIC) is often underdiagnosed due to inconsistent definitions and perceived reversibility. The treatment focuses on early arrhythmia control, but the impact of guideline-directed medical therapy (GDMT) on left ventricular ejection fraction (LVEF) improvement has not been fully explored.</p><p><strong>Materials and methods: </strong>This multicentric prospective registry study included patients with newly onset HF and reduced ejection fraction (HFrEF). Data were collected on clinical characteristics, echocardiographic and laboratory parameters, pharmacological treatment, and follow-up events. The statistical analyses focused on TIC patients, analyzing the event rates and the influence of GDMT on LVEF improvement according to sinus rhythm (SR) restoration.</p><p><strong>Results: </strong>Among 808 patients, 174 (21.5%) were diagnosed with TIC, with an age of 67.2 (SD: 9.4) years. After a median follow-up of 3.5 months [IQR: 2.6-4.3], SR was restored in 56.8% of patients, and LVEF improved from 29.6 to 49%. The increase was more pronounced in patients who restored SR compared to those remaining in atrial fibrillation (AF) (22.4% vs. 15.1%; p < 0.05). The natriuretic peptides significantly decreased in the SR group (- 1883.7 pg/mL) but did not in the AF group. The overall readmission rate was 25.1% and the overall mortality rate was 3.6%, with no significant differences between patients who achieved SR and those with persistent AF at the end of up-titration. HF readmission was infrequent (4%) despite AF persistence. Early GDMT was initiated in TIC patients, regardless of SR recovery and significantly improved LVEF, especially in AF patients [RR = 4.24 (95% CI: 1.44-12.45)] compared to SR patients [(RR = 1.41 95% CI: 1.02-1.92)].</p><p><strong>Conclusions: </strong>TIC represents a significant proportion of HFrEF patients, with early restoration of SR leading to greater LVEF improvement. Despite AF persistence, HF readmissions were rare, highlighting the efficacy of early quadruple therapy. Enhanced adherence to GDMT should be prioritized, particularly in patients with persistent AF.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"774-784"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970547","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":"Cardiac transthyretin amyloidosis in aortic valve replacement: RAISE score performance in the postoperative setting.","authors":"Richard J Nies, Svenja Ney, Jasper F Nies, Katharina Seuthe, Jan Grobecker, Friedrich Gruenagel, Stephan Nienaber, Merve Kural, Sascha Macherey-Meyer, Matthieu Schäfer, Clemens Metze, Matti Adam, Maria Papathanasiou, Can Öztürk, Amin Polzin, Fabian Voß, Stephan Baldus, Roman Pfister","doi":"10.1007/s00392-025-02766-6","DOIUrl":"10.1007/s00392-025-02766-6","url":null,"abstract":"<p><strong>Aims: </strong>The RAISE Score, encompassing five domains (Remodeling, Age, Injury, Systemic, Electrical), was proposed to screen for transthyretin amyloid cardiomyopathy (ATTR-CM) in patients with aortic stenosis (AS), but is not routinely used. This study evaluated its performance following aortic valve replacement (AVR).</p><p><strong>Methods: </strong>This single-center, prospective, observational study included patients aged ≥ 60 years with end-diastolic interventricular septum thickness (IVSd) ≥ 12 mm, who underwent hydroxydiphosphonate (HDP) bone scintigraphy after AVR between March 2021 and July 2024. The diagnostic performance of the RAISE Score assessed at 30-day follow-up and of simpler screening parameters for pathological HDP uptake (Perugini 1-3) were analyzed, along with their association with all-cause mortality and heart failure (HF) hospitalization.</p><p><strong>Results: </strong>Among 131 included patients (median age 81 years; 64% male) pathological HDP uptake was found in 21 (16%), and 11 (8.4%) were diagnosed with ATTR-CM. A RAISE Score ≥ 2 demonstrated 76% sensitivity and 56% specificity for pathological bone scintigraphy, while a Score ≥ 3 showed 62% sensitivity and 78% specificity. The parameters age ≥ 83 years and the combination of carpal tunnel syndrome (CTS) and/or N-terminal pro-B-type natriuretic peptide (NT-proBNP) ≥ 1,400 pg/mL performed similarly to the RAISE Score. Cardiac HDP uptake showed a strong trend toward HF hospitalization (HR [95%-CI]: 5.81 [0.93-36.20]; p = 0.060) and all-cause mortality (HR [95%-CI]: 3.27 [0.95-11.24]; p = 0.060). CTS and/or NT-proBNP ≥ 1,400 pg/mL was significantly associated with higher all-cause mortality (HR [95%-CI]: 3.92 [1.04-14.84]; p = 0.044), whereas the RAISE Score was not.</p><p><strong>Conclusion: </strong>After AVR, the complex RAISE Score showed lower sensitivity than originally reported, while simpler parameters demonstrated comparable predictive value for ATTR-CM screening. Advanced age, CTS history and elevated NT-proBNP levels seem most valuable for identifying candidates for bone scintigraphy.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"826-841"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13083505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"QTc interval prolongation as a marker of disease stage in transthyretin cardiac amyloidosis.","authors":"Theodoros Tsampras, Alexios S Antonopoulos, Freideriki-Eleni Kourti, Konstantinos Tsioufis, Charalambos Vlachopoulos","doi":"10.1007/s00392-025-02680-x","DOIUrl":"10.1007/s00392-025-02680-x","url":null,"abstract":"<p><p>Transthyretin amyloidosis is a significant cause of heart failure with an unfavorable prognosis. In recent years, diagnosing the disease has become easier, with most patients now diagnosed non-invasively, and tissue biopsy being required only in a minority of cases. Although various laboratory findings have been reported as transthyretin amyloidosis red flags, the diagnostic and prognostic value of various electrocardiogram parameters remain largely unknown. In this study, the significance of QTc interval prolongation in transthyretin cardiac amyloidosis patients was investigated. We retrospectively analyzed electrocardiogram data from n = 58 patients with transthyretin amyloid cardiomyopathy and compared them with distinct cohorts of patients diagnosed with other forms of heart muscle disease, i.e., hypertrophic cardiomyopathy and dilated cardiomyopathy. QTc prolongation was found to be a unique feature of transthyretin cardiac amyloidosis, not shared by other cardiomyopathy types. Increased QTc interval in transthyretin amyloidosis patients correlates with disease severity markers, including NYHA class, NAC stage, NT-proBNP, and troponin I levels, suggesting its potential as a unique biomarker for monitoring disease progression.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"894-898"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552457","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}