Clinical Research in Cardiology最新文献

{"title":"Prior hospitalizations as a predictor of prognosis in heart failure with mildly reduced ejection fraction.","authors":"Henning Johann Steffen, Michael Behnes, Alexander Schmitt, Noah Abel, Felix Lau, Marielen Reinhardt, Muharrem Akin, Thomas Bertsch, Mohamed Ayoub, Kambis Mashayekhi, Kathrin Weidner, Ibrahim Akin, Tobias Schupp","doi":"10.1007/s00392-025-02612-9","DOIUrl":"https://doi.org/10.1007/s00392-025-02612-9","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the prognostic impact of the presence and type of prior hospitalizations in patients with heart failure with mildly reduced ejection fraction (HFmrEF).</p><p><strong>Background: </strong>Data investigating the prognostic impact of the present and type of previous all-cause hospitalizations in HFmrEF is limited.</p><p><strong>Methods: </strong>Consecutive patients hospitalized with HFmrEF at a single medical center were retrospectively included from 2016 to 2022. The prognosis of patients with a prior hospitalization < 12 months was compared to patients without. The primary endpoint was all-cause mortality at 30 months (median follow-up), the key secondary endpoint was heart failure (HF)-related rehospitalization at 30 months.</p><p><strong>Results: </strong>Two thousand one hundred eighty four patients with HFmrEF were included, 34.8% had a previous hospitalization < 12 months (admission to internal medicine and geriatrics: 60.8%, surgical department: 23.5%). The presence of a previous hospitalization was associated with an increased risk of all-cause mortality (38.6% vs. 27.4%; HR = 1.51; 95% CI 1.30-1.76; p = 0.01) and HF-related rehospitalization at 30 months (21.2% vs. 9.1%; HR = 2.48; 95% CI 1.96-3.14; p = 0.01), even after multivariable adjustments. However, the department of previous hospitalization (internal medicine vs. surgical) did not significantly affect the risk of 30-months all-cause mortality (37.1% vs. 43.2%; HR = 0.82, 95% CI 0.63-1.08; p = 0.16) or HF-related rehospitalization (24.0% vs. 16.8%; HR = 1.47, 95% CI 0.98-2.24; p = 0.07). Finally, the type of previous admission (i.e., elective, emergency vs. HF-related admission) (log-rank p = 0.29) did not affect the risk of 30-months all-cause mortality.</p><p><strong>Conclusion: </strong>Prior hospitalizations within 12 months were independently associated with impaired long-term mortality in patients with HFmrEF, irrespective of the department or type of prior admission.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440201","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":"Quantitative perfusion by cardiac magnetic resonance imaging reveals compromised myocardial perfusion in patients with angina with non-obstructive coronary artery disease.","authors":"Caitlin E M Vink, Sonia Borodzicz-Jazdzyk, Elize A M de Jong, Janneke Woudstra, Tim P van de Hoef, Steven A J Chamuleau, Etto C Eringa, Marco J W Götte, Yolande Appelman","doi":"10.1007/s00392-025-02606-7","DOIUrl":"https://doi.org/10.1007/s00392-025-02606-7","url":null,"abstract":"<p><strong>Introduction: </strong>Stress perfusion cardiac magnetic resonance (CMR) effectively detects myocardial ischemia. In angina with non-obstructive coronary arteries (ANOCA), visually assessed first-pass perfusion often appears normal. Automated quantitative perfusion (QP) might benefit ANOCA diagnosis, offering absolute quantification of myocardial blood flow (MBF) and myocardial perfusion reserve (MPR).</p><p><strong>Aim: </strong>We aimed to evaluate the efficacy of QP in detecting ANOCA.</p><p><strong>Methods: </strong>This study compared fully automated QP CMR in ANOCA patients with age- and sex-matched healthy controls. Participants underwent adenosine stress perfusion CMR, including visual assessment and quantification of MBF and MPR. ANOCA patients underwent coronary function testing to identify vasospasm and/or coronary microvascular dysfunction.</p><p><strong>Results: </strong>Twenty-four ANOCA patients (83% women, 57 ± 9 years) and 25 healthy controls (80% women, 56 ± 7 years) were included. Visual perfusion assessment did not differ between groups (p = 0.54). Additionally, no differences in resting MBF were observed. However, ANOCA patients had significantly lower global MBF during stress (2.43 ± 0.72 vs 2.99 ± 0.65 ml/g/min, p < 0.01) and a significantly lower global MPR (2.24 ± 0.79 vs 2.68 ± 0.64, p = 0.04) compared to healthy controls. MPR was significantly reduced in the RCA territory in ANOCA patients (2.16 ± 0.71 vs 2.69 ± 0.69, p = 0.01), with no significant differences in other coronary territories. MPR did not significantly differ between ANOCA endotypes.</p><p><strong>Conclusions: </strong>ANOCA patients display reduced global MPR, suggesting compromised perfusion. Variation in MPR across coronary territories highlights the importance of assessing perfusion in all teritories. These findings are promising and support the use of QP for non-invasive detection of vasomotor dysfunction in ANOCA patients.</p><p><strong>Pre-registered clinical trial number: </strong>The pre-registered clinical trial number is NL-OMON23861.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448504","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":"Hyperkalemia-induced Brugada phenocopy: a systematic review of case reports.","authors":"Asmaa Zakria Alnajjar, Afnan Ismail Ibrahim, Mohamed Ellebedy","doi":"10.1007/s00392-025-02607-6","DOIUrl":"https://doi.org/10.1007/s00392-025-02607-6","url":null,"abstract":"<p><strong>Background: </strong>Hyperkalemia-induced Brugada phenocopy is a transient electrocardiographic pattern that mimics the features of Brugada syndrome but is triggered by an elevation in serum levels of potassium. The objective of conducting this systematic review of case reports on hyperkalemia-induced BrP was to combine cases and increase the understanding base driving the clinical practice.</p><p><strong>Methods: </strong>We conducted a literature search in PubMed, WOS, Cochrane, and Scopus up to July 2024 for case reports of BrP induced by hyperkalemia. We considered case reports of patients with hyperkalemia and Brugada-like changes on ECG that resolved with the correction of hyperkalemia for inclusion. Extracted data included patient demographics, clinical presentation, ECG findings, potassium levels, management, and the outcomes.</p><p><strong>Results: </strong>Thirty-one case reports fit our inclusion criteria. Their ages ranged from 12 to 89years, with 60% being male. Most of the patients presented with symptoms of hyperkalemia such as weakness, palpitations, and chest pain. The ECG changes were typical of BrP and included the coved-type ST-segment elevation in leads V1-V3. The potassium levels at presentation varied from 6.1mmol/L to 9.5 mmol/L. The management strategies principally involved correction of hyperkalemia using intravenous calcium, insulin with glucose, and diuretics. In all patients, normalization of the potassium level was associated with resolution of the Brugada-like ECG pattern.</p><p><strong>Conclusion: </strong>Systemic hyperkalemia may induce BrP, a condition frequently mimicked on the ECG by Brugada syndrome and which resolves by properly treating the hyperkalemia. Such awareness will facilitate the making of an accurate diagnosis and management of this condition, avoiding unnecessary interventions based on Brugada syndrome. Further studies should aim at explaining the underlying pathophysiological mechanisms and the legislation of diagnostic criteria for hyperkalemia-induced BrP.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440199","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":"A call for high-intensity lipid-lowering treatment of ASCVD patients diagnosed by coronary computed tomography angiography: lessons from the multi-center LOCATE study.","authors":"Franz Haertel, Ulf Teichgräber, P Christian Schulze, Oliver Weingärtner","doi":"10.1007/s00392-025-02604-9","DOIUrl":"https://doi.org/10.1007/s00392-025-02604-9","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390294","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":"Dual pathway inhibition in patients with coronary artery disease (CAD) in clinical practice in Germany: results from the German CAD subgroup of the XATOA Registry.","authors":"Uwe Zeymer, Rupert M Bauersachs, Nikolaos Dagkonakis, E Sebastian Debus, Joerg Herold, Sonia S Anand, Keith A A Fox, Victor Aboyans, Ursula Rauch-Kröhnert","doi":"10.1007/s00392-025-02603-w","DOIUrl":"https://doi.org/10.1007/s00392-025-02603-w","url":null,"abstract":"<p><strong>Aims: </strong>To determine characteristics and clinical outcomes of German patients with coronary artery disease (CAD) with or without peripheral artery disease (PAD) who initiated dual pathway inhibition (DPI) using rivaroxaban 2.5 mg twice daily plus aspirin 100 mg once daily in clinical practice in Germany and to compare those with the results for CAD patients of the COMPASS trial.</p><p><strong>Methods and results: </strong>XATOA was an international prospective registry with a mean follow-up period of 15 months. There were 1641 German CAD patients included, of which 747 patients (45.5%) had CAD only and 894 patients (54.5%) had both CAD and PAD. Baseline characteristics (age, sex, medical history, prior medications) were similar between the subgroups of German CAD patients and comparable to CAD patients of COMPASS. The incidence of major adverse cardiovascular events (MACE) was comparable between CAD patient subgroups of XATOA Germany (only CAD patients: 3.7%, CAD + PAD patients: 3.9%) and was similar to the incidence for CAD patients overall in XATOA and in COMPASS (All CAD patients XATOA: 3.8% vs. 4.2% COMPASS CAD). Incidence for major bleeding was markedly lower in CAD patients of XATOA Germany compared to COMPASS CAD patients (All CAD patients XATOA: 1.1% vs. 3.2% in COMPASS CAD).</p><p><strong>Conclusion: </strong>In this real world experience among German patients with CAD enrolled in XATOA, DPI with rivaroxaban and aspirin was associated with low incidence of MACE and major bleeding.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390323","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":"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}