Clinical Research in Cardiology最新文献

{"title":"Inflammation, Lp(a) and cardiovascular mortality: results from the LURIC study.","authors":"Stephanie Wissel, Hubert Scharnagl, Marcus E Kleber, Graciela Delgado, Angela Moissl, Bernhard Krämer, Winfried März","doi":"10.1007/s00392-025-02609-4","DOIUrl":"https://doi.org/10.1007/s00392-025-02609-4","url":null,"abstract":"<p><strong>Objective: </strong>Lipoprotein(a) [Lp(a)] concentrations have been associated with cardiovascular risk. Recent studies suggested an interaction between systemic inflammation assessed via high-sensitivity C-reactive protein (hsCRP) and Lp(a). This study aimed to evaluate whether Lp(a), hsCRP, and interleukin-6 (IL-6) levels are associated with cardiovascular mortality in a German hospital-based cohort.</p><p><strong>Methods: </strong>Data were drawn from the Ludwigshafen Risk and Cardiovascular Health (LURIC) study, including 3,316 patients undergoing coronary angiography. Lp(a) was measured by immunoturbidimetry and categorized into three strata (< 50 mg/dL, n = 2668; 50-100 mg/dL, n = 482; > 100 mg/dL, n = 163). HsCRP was measured by immunonephelometry and categorized by intervals (1st < 1 mg/L, 2nd 1-2 mg/L and 3rd interval > 2 mg/L). IL-6 was measured by ELISA and categorized into two groups (1st < 3.2 ng/L, 2nd ≥ 3.2 ng/L). The primary outcome was cardiovascular disease (CVD) mortality, analyzed using Cox proportional hazards models and logistic regression.</p><p><strong>Results: </strong>Participants were predominantly male, with a mean age of 62.6 years. Extremely high Lp(a) (> 100 mg/dL) was associated with increased cardiovascular mortality (HR 1.5, 95% CI 1.06-2.12) compared to Lp(a) < 50 mg/dl. Both hsCRP (> 2 mg/L, HR 1.39, 95% CI 1.08-1.79 third vs. first interval) and more so IL-6 (HR 1.92, 95% CI 1.64-2.23, upper vs. lower half), were independently associated with higher CVD mortality. While hsCRP did not increase the Lp(a)-CVD mortality in stratified analysis, high IL-6 conferred an increased risk at Lp(a) levels > 100 mg/dL (HR 1.25, 95% CI 1.09-1.44).</p><p><strong>Conclusion: </strong>HsCRP and IL-6 are associated with cardiovascular mortality. Markedly elevated Lp(a) is associated with an increased risk of cardiovascular mortality in the context of high systemic inflammation. Anti-inflammatory treatments may provide additional therapeutic benefits for individuals with high Lp(a).</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255029","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":"Manual support during robotic-assisted percutaneous coronary intervention.","authors":"Benjamin Bay, Alina Goßling, Jonathan Rilinger, Constantin von Zur Mühlen, Felix Hofmann, Holger Nef, Helge Möllmann, Caroline Kellner, Moritz Seiffert, Fabian J Brunner","doi":"10.1007/s00392-025-02596-6","DOIUrl":"https://doi.org/10.1007/s00392-025-02596-6","url":null,"abstract":"<p><strong>Background: </strong>Robotic-assisted percutaneous coronary intervention (R-PCI) is an efficacious and safe treatment option for coronary artery disease. However, predictors of manual support during R-PCI are unknown, which we aimed to investigate in a multi-center study.</p><p><strong>Methods: </strong>We utilized patient-level data from R-PCIs carried out from 2020 to 2022 at four sites in Germany. Manual support was defined as the combination of partial manual assistance, where the procedure is ultimately completed using robotic techniques, and manual conversion. A two-step selection process based on akaike information criteria was used to identify the ideal multivariable model predicting manual support.</p><p><strong>Results: </strong>In 210 patients (median age 69.0 years; 25.7% female), a total of 231 coronary lesions were treated by R-PCI. Manual support was needed in 46 lesions (19.9%). Procedures requiring manual support were associated with significantly longer procedural times, greater total contrast fluid volumes, longer fluoroscopy times, and higher dose-area products. Amongst the predictors of manual support were lesions in the left anterior descending artery [OR: 1.09 (95%-CI: 0.99-1.20)], aorto-ostial lesions [OR: 1.35 (95%-CI: 1.11-1.64)], chronic total occlusions [OR: 1.78 (95%-CI: 1.38-2.31)], true bifurcations [OR: 1.37 (95%-CI: 1.17-1.59)], and severe calcification [OR: 1.13 (95%-CI: 1.00-1.27)].</p><p><strong>Conclusion: </strong>Our findings reveal that nearly one out five of patients undergoing R-PCI required manual support, which was linked to longer procedure durations. Predictors of manual support reflected characteristics of more complex coronary lesions. These results highlight the limitations of current R-PCI platforms and underscore the need for technical advancements to address different clinical scenarios.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255032","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":"Response to the Letter to the editor: \"cardiovascular magnetic resonance reveals myocardial involvement in patients with active stage of inflammatory bowel disease\" (CRCD-D-24-01694).","authors":"Maximilian Fenski, Jeanette Schulz-Menger","doi":"10.1007/s00392-025-02600-z","DOIUrl":"https://doi.org/10.1007/s00392-025-02600-z","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254981","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 GDMT on outcomes after mitral valve edge-to-edge repair stratified by SMR proportionality.","authors":"Lukas Stolz, Daniel Kalbacher, Benedikt Koell, Nicole Karam, Tania Puscas, Marco Metra, Marianna Adamo, Maximilian Spieker, Patrick Horn, Holger Thiele, Tobias Kister, Ralph-Stephan von Bardeleben, Philipp Lurz, Karl-Patrik Kresoja, Christos Iliadis, Roman Pfister, Mohammad Kassar, Fabien Praz, Bruno Melica, Teresa Trenkwalder, Erion Xhepa, Michael Neuss, Christian Butter, Paul Grayburn, Jörg Hausleiter","doi":"10.1007/s00392-025-02599-3","DOIUrl":"https://doi.org/10.1007/s00392-025-02599-3","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255025","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":"Letter to the editor: \"Cardiovascular magnetic resonance reveals myocardial involvement in patients with active stage of inflammatory bowel disease\".","authors":"Syeda Rabika, Syeda Sidra Mudassir, Muhammad Maaz, Syed Hussain","doi":"10.1007/s00392-025-02605-8","DOIUrl":"https://doi.org/10.1007/s00392-025-02605-8","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188548","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":"Spontaneous blood pressure reduction of previously hypertensive patients as a symptom of central pulmonary artery embolism.","authors":"R Schell, F Alban, N Frey, C Erbel","doi":"10.1007/s00392-023-02315-z","DOIUrl":"10.1007/s00392-023-02315-z","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"281-286"},"PeriodicalIF":3.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41093496","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":"Correction: Robustness of tricuspid regurgitation reduction at 1 year following edge-to-edge repair for primary tricuspid regurgitation.","authors":"Felix Rudolph, Muhammed Gerçek, Johannes Kirchner, Maria Ivannikova, Kai P Friedrichs, Tanja K Rudolph, Volker Rudolph, Martin Andreas, Anna Bartunek, Philipp E Bartko, Varius Dannenberg","doi":"10.1007/s00392-024-02590-4","DOIUrl":"10.1007/s00392-024-02590-4","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"290"},"PeriodicalIF":3.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799183","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":"Exercise testing in patients with tricuspid regurgitation undergoing transcatheter tricuspid valve intervention.","authors":"Muhammed Gerçek, Maria Ivannikova, Arseniy Goncharov, Mustafa Gerçek, Maximilian Mörsdorf, Johannes Kirchner, Felix Rudolph, Tanja K Rudolph, Volker Rudolph, Kai P Friedrichs, Daniel Dumitrescu","doi":"10.1007/s00392-024-02554-8","DOIUrl":"10.1007/s00392-024-02554-8","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter tricuspid valve intervention (TTVI) has shown promising results with persistent reduction of tricuspid regurgitation (TR) and improvements in functional class and quality of life (QOL).</p><p><strong>Objectives: </strong>To analyze the impact of TTVI on maximal and submaximal exercise capacity (SEC).</p><p><strong>Methods: </strong>Constant work-rate exercise-time (CWRET) testing reflects SEC, which is more likely to be relevant for daily life activities and provides more differentiated physiological insight into the nature of exercise intolerance. Thus, 30 patients undergoing TTVI (21 direct annuloplasty and 9 edge-to-edge repair) received cardiopulmonary exercise testing (CPET) and CWRET (at 75% of maximum work rate in the initial CPET) before and 3 months after TTVI.</p><p><strong>Results: </strong>Patients' age was 80.5 [74.8-82.3] years and 53.3% were female. TR reduction ≥ 2 grades was achieved in 93.3% (TR grade ≤ moderate in 83.3%). Echocardiography revealed improved right ventricular (RV) characteristics with decreased RV basal diameter (47.0 mm [43.0-54.3] vs. 41.5 mm [36.8-48.0]; p < 0.001) and decreased inferior caval vein diameter. CWRET testing showed a significantly improved SEC (246.5 s [153.8-416.8] vs. 338.5 s [238.8-611.8] p = 0.001). Maximum oxygen uptake showed a positive trend without statistically significant differences (9.9 ml/min/kg [8.6-12.4] vs. 11.7 ml/min/kg [9.7-13.3]; p = 0.31). In contrast to the six-minute-walking distance (6MWD), SEC correlated moderately with effective regurgitation orifice area reduction (r = 0.385; p = 0.036), increased cardiac output (r = 0.378; p = 0.039), and improved QOL (r = 387; p = 0.035).</p><p><strong>Conclusion: </strong>Improvements in exercise capacity after TTVI mainly occur in the submaximal rather than in the maximal exercise range and correlate with hemodynamic effects and QOL. This may have a methodological impact on assessment of exercise capacity in these patients.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"261-271"},"PeriodicalIF":3.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388634","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":"Right ventricular function and dimensions in patients undergoing transcatheter aortic valve replacement assessed by three-dimensional echocardiography.","authors":"Lukas Stolz, Simon Schmid, Julius Steffen, Philipp M Doldi, Hans D Theiss, Kornelia Löw, Magda Haum, Steffen Massberg, Jörg Hausleiter, Simon Deseive","doi":"10.1007/s00392-024-02530-2","DOIUrl":"10.1007/s00392-024-02530-2","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"287-289"},"PeriodicalIF":3.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132061","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":"Right ventricular to pulmonary artery coupling in patients with different types of aortic stenosis undergoing TAVI.","authors":"Julius Steffen, Melanie Lux, Thomas J Stocker, Nikolaus Kneidinger, Kornelia Löw, Philipp M Doldi, Magda Haum, Julius Fischer, Lukas Stolz, Hans Theiss, Konstantinos Rizas, Daniel Braun, Martin Orban, Sven Peterß, Jörg Hausleiter, Steffen Massberg, Simon Deseive","doi":"10.1007/s00392-024-02457-8","DOIUrl":"10.1007/s00392-024-02457-8","url":null,"abstract":"<p><strong>Background: </strong>Right ventricular (RV) dysfunction in patients undergoing transcatheter aortic valve implantation (TAVI) for aortic stenosis (AS) has long been disregarded. We aimed to assess the predictive value of RV to pulmonary artery coupling (RV/PAc), defined as tricuspid annular plane systolic excursion to systolic pulmonary artery pressure, on mortality in different flow types of AS after TAVI.</p><p><strong>Methods: </strong>All patients undergoing TAVI for AS at our centre between 2018 and 2020 were assessed; 862 patients were analysed. The cohort was dichotomized using a ROC analysis (cut-off 0.512 mm/mmHg), into 429 patients with preserved and 433 patients with reduced RV/PAc.</p><p><strong>Results: </strong>Reduced RV/PAc was associated with male sex and a higher rate of comorbidities. Short-term VARC-3 endpoints and NYHA classes at follow-up were comparable. Reduced RV/PAc was associated with higher 2-year all-cause mortality (35.0% [30.3-39.3%] vs. 15.4% [11.9-18.7%], hazard ratio 2.5 [1.9-3.4], p < 0.001). Cardiovascular mortality was almost tripled. Results were consistent after statistical adjustment and in a multivariate model. Sub-analyses of AS flow types revealed lower RV/PAc in classical and paradoxical low-flow low-gradient AS, with the majority having reduced RV/PAc (74% and 59%). RV/PAc retained its predictive value in these subgroups.</p><p><strong>Conclusions: </strong>RV dysfunction defined by low RV/PAc is a strong mortality predictor after TAVI independent of flow group. It should be incorporated in future TAVI risk assessment.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"227-238"},"PeriodicalIF":3.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140921516","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}