Clinical Research in Cardiology最新文献

{"title":"Impact of diabetes on outcomes of patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease undergoing percutaneous coronary intervention.","authors":"Philipp Jakob, Ferdinando Varbella, Axel Linke, Bettina Schwarz, Stephan B Felix, Moritz Seiffert, Rahel Kesterke, Peter Nordbeck, Bernhard Witzenbichler, Irene M Lang, Mirjam Kessler, Christian Valina, Alban Dibra, Miklos Rohla, Marco Moccetti, Matteo Vercellino, Luise Gaede, Lorenz Bott-Flügel, Julia Stehli, Alessandro Candreva, Francesco Paneni, Christian Templin, Matthias Schindler, Manfred Wischnewsky, Greca Zanda, Giorgio Quadri, Norman Mangner, Aurel Toma, Giulia Magnani, Peter Clemmensen, Thomas F Lüscher, Thomas Münzel, P Christian Schulze, Karl-Ludwig Laugwitz, Wolfgang Rottbauer, Kurt Huber, Franz-Josef Neumann, Steffen Schneider, Thomas Riemer, Franz Weidinger, Stephan Achenbach, Gert Richardt, Adnan Kastrati, Ian Ford, Frank Ruschitzka, Barbara E Stähli","doi":"10.1007/s00392-025-02745-x","DOIUrl":"https://doi.org/10.1007/s00392-025-02745-x","url":null,"abstract":"<p><strong>Background: </strong>Diabetic patients with ST-segment elevation myocardial infarction (STEMI) are at an increased risk of cardiovascular events as compared to non-diabetic patients. This analysis investigated outcomes of diabetic patients presenting with multivessel disease (MVD) and STEMI in a contemporary trial and the relevance of an immediate versus staged multivessel PCI strategy in this high-risk population.</p><p><strong>Methods: </strong>Patients enrolled in the MULTISTARS AMI trial were stratified according to the presence/absence of diabetes. Baseline characteristics and outcomes of diabetic and non-diabetic patients were compared. The primary end point was a composite of all-cause death, non-fatal myocardial infarction, stroke, unplanned ischemia-driven revascularization, or hospitalization for heart failure at 1 year.</p><p><strong>Results: </strong>In the MULTISTARS AMI trial, out of a total of 840 patients, 131 (15.6%) patients had diabetes. Patients with diabetes had a higher cardiovascular risk profile and worse kidney function. The occurrence of the primary end point was similar between patients with and without diabetes (HR, 1.14 (95% CI, 0.69-1.90), p-value = 0.60). Rates of non-cardiovascular death (HR, 6.53 (95% CI, 2.00-21.33)) and acute renal failure (HR, 3.23 (95% CI, 1.49-7.04)) were higher in diabetic patients as compared to non-diabetic patients. Comparing an immediate with a staged PCI strategy in diabetic patients, a numerically lower number of patients in the immediate PCI group experienced a primary end point event (10.6% vs. 16.9%, HR, 0.60 (95% CI, 0.23-1.53), p-value = 0.28).</p><p><strong>Conclusion: </strong>Among diabetic patients with STEMI and MVD, a strategy of immediate multivessel PCI may be safe and comparable to a strategy of staged multivessel PCI.</p><p><strong>Trial registration: </strong>Supported by Boston Scientific; MULTISTARS AMI ClinicalTrials.gov number, NCT03135275.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029182","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":"Prescription of lipid-lowering drugs and their association with hospitalization for ST-elevation myocardial infarction (STEMI) in Germany in 2010-2022.","authors":"Knut Kröger, Karsten Wiemes, Frans Santosa, Hinrich Böhner, Hildegard Lax, Susanne Stolpe, Bernd Kowall, Andreas Stang","doi":"10.1007/s00392-025-02739-9","DOIUrl":"https://doi.org/10.1007/s00392-025-02739-9","url":null,"abstract":"<p><strong>Objectives: </strong>We investigated changes in lipid-lowering drug prescriptions in Germany as a whole and in the 16 federal states over the last 13 years and their association with hospitalization rates for acute myocardial infarction.</p><p><strong>Design: </strong>Ecological study.</p><p><strong>Setting: </strong>Nationwide German hospitalization, Diagnosis-Related Groups Statistic.</p><p><strong>Patients/participants: </strong>German population in the years 2010 through 2022.</p><p><strong>Intervention: </strong>All prescriptions of lipid-lowering drugs in the years 2010 to 2022 by federal state in Germany.</p><p><strong>Main outcome measures: </strong>Hospitalization rates for the treatment of transmural infarction per calendar year and federal state (STEMI = ST-elevation myocardial infarction).</p><p><strong>Results: </strong>The age-standardized prescription rates of lipid-lowering drugs per 1000 person-years increased from 77.4 in 2010 to 145.2 in 2022 (reference population: Germany 2011). Within the same period, the STEMI hospitalization rate per 100,000 person-years decreased from 143.7 to 100.1. Based on the prescription and hospitalization rates of the 16 federal states, it is shown that the STEMI hospitalization rate decreased the more the prescription rate of lipid-lowering drugs in a federal state increased over time (beta = 0.38, 95% confidence interval - 0.64; - 0.12; adjusted explained variance 0.362).</p><p><strong>Conclusion: </strong>Increasing prescription rates of lipid-lowering drugs have correlated with decreasing rates of hospitalized cases for STEMI in Germany in the last decade.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014012","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":"Validation of angiography-based FFR in non-culprit vessels of patients presenting with STEMI.","authors":"Jari A van der Eijk, Frederik T W Groenland, Alessandra Scoccia, Annemieke C Ziedses des Plantes, Jager Huang, Rutger-Jan Nuis, Jeroen M Wilschut, Wijnand K den Dekker, Roberto Diletti, Isabella Kardys, Mariusz Tomaniak, Nicolas M Van Mieghem, Joost Daemen","doi":"10.1007/s00392-025-02729-x","DOIUrl":"https://doi.org/10.1007/s00392-025-02729-x","url":null,"abstract":"<p><strong>Background: </strong>Fractional flow reserve (FFR) for non-culprit lesions (NCLs) in patients with ST-elevation myocardial infarction (STEMI) can be influenced by temporary changes in microvascular resistance. Angiography-derived vessel fractional flow reserve (vFFR) has been tested as a less-invasive alternative.</p><p><strong>Aims: </strong>The FAST STEMI II study aimed to assess the diagnostic performance of acute-setting vFFR vs. FFR for intermediate NCLs in STEMI patients.</p><p><strong>Methods: </strong>FAST STEMI II is a prospective two-center cohort study including STEMI patients with ≥ 1 intermediate NCL (50-90% diameter stenosis). Patients with cardiogenic shock, prior revascularization of the non-culprit vessel, or aorta-ostial lesions were excluded. Following primary percutaneous coronary intervention (PCI), vFFR, FFR, resting full-cycle ratio (RFR), coronary flow reserve (CFR), and index of microcirculatory resistance (IMR) measurements of the NCL were performed.</p><p><strong>Results: </strong>A total of 111 patients were included. Median [25th-75th percentile] vFFR and FFR were 0.83 [0.74-0.88] and 0.83 [0.80-0.90], respectively. vFFR had a moderate to good discriminative ability to predict FFR ≤ 0.80 (AUC: 0.78; 95% CI: 0.68-0.89; p < 0.001) with a moderate correlation (r = 0.54; p < 0.001). Diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of vFFR to predict FFR ≤ 0.80 were 72%, 76%, 70%, 53%, and 87%, respectively. Microvascular dysfunction (CFR < 2.0 and IMR ≥ 25) was observed in 33 (31%) patients. In patients with microvascular dysfunction, median vFFR and FFR values were 0.76 [0.71-0.86] and 0.85 [0.77-0.90], respectively (p = 0.002).</p><p><strong>Conclusions: </strong>We found moderate correlation between vFFR and FFR in NCLs of patients undergoing primary PCI. Discordance between vFFR and FFR was associated with the presence of microvascular dysfunction. The study was conducted in accordance with Good Clinical Practice and the Declaration of Helsinki and was registered at 22-jun-2023 on clinicaltrials.gov under the identifier NCT05698719.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022977","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 pulmonary hypertension dynamics and residual mitral regurgitation shortly after M-TEER on long-term outcomes: insights from a prospective registry.","authors":"Miroslav Hudec, Jaroslav Januska, Otakar Jiravsky, Roman Miklik, Martin Urban, Miloslav Dorda, Alica Cesnakova Konecna, Libor Gajdusek, Ivan Ranic, David Vician, Radim Spacek, Bogna Jiravska Godula, Libor Sknouril, Petr Kala","doi":"10.1007/s00392-025-02747-9","DOIUrl":"https://doi.org/10.1007/s00392-025-02747-9","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary hypertension (PH) often coexists in patients undergoing transcatheter edge-to-edge mitral valve repair procedure (M-TEER). Its pre-procedural severity is considered a negative prognostic marker. Whether the post-procedural PH resulting from M-TEER can also serve as a long-term prognostic marker is unknown.</p><p><strong>Aims: </strong>To evaluate the influence of residual mitral regurgitation (MR) and the role of PH dynamics on long-term outcome after M-TEER.</p><p><strong>Methods: </strong>A total of 226 patients from a single-centre prospective registry who underwent M-TEER with MitraClips between 2010 and 2022 were analysed. Patients were categorised into four phenotype groups based on a combination of post-procedural MR severity (≤ 2.5 vs. ≥ 3) and change in PH (stable/improved vs. worsened). Primary endpoints were survival, time to first heart failure hospitalisation (HFH) and a composite of both.</p><p><strong>Results: </strong>Overall, 86.3% of patients had severe MR and 59.7% had PH at baseline, while 75.7% had MR ≤ 2.5 and 57.5% had no residual PH after M-TEER on discharge echocardiography. Baseline PH severity did not significantly influence outcomes, but its dynamics did (stable/improved vs. worsening; median survival 63 vs. 38 months, time to HFH 74 vs. 44 months, and time to composite endpoint 49 vs. 26 months, all p < 0.05). Patients who achieved mild/moderate MR with stable/improved PH (81.0%) showed the best results across all endpoints (median survival 58 months, p = 0.027; time to HFH 74 months, p = 0.004; time to composite endpoint 50 months, p = 0.008). The groups with worsening PH after M-TEER had the worst outcomes, regardless of the degree of MR.</p><p><strong>Conclusion: </strong>Assessment of pH dynamics shortly after M-TEER proved to be a valuable predictor of long-term outcome. Its combination with the post-procedural level of MR can easily identify patients at low or high risk of subsequent adverse outcomes.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022940","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 atrial epicardial adipose tissue volume quantification by CMR aids identification of patients at low risk for left atrial cardiomyopathy.","authors":"T R Schmidt, S Ulbrich, T Gaspar, M Wagner, S Richter, A Linke, F M Heidrich","doi":"10.1007/s00392-025-02718-0","DOIUrl":"10.1007/s00392-025-02718-0","url":null,"abstract":"<p><strong>Background and aims: </strong>The pathophysiologic concept of atrial fibrillation (AF) has evolved towards defining atrial cardiomyopathy, recognizing inflammation-mediated remodeling of the left atrium (LA) as a source for arrhythmogenesis. One feature of atrial cardiomyopathy is the development of fibrosis, with low-voltage zones (LVZ) identified by invasive electroanatomic mapping as an accepted surrogate parameter. A mediator of pathological remodeling is epicardial adipose tissue (EAT). This study sought to explore LA-EAT volume, as a predictor of LVZ in patients presenting for primary AF ablation.</p><p><strong>Methods and results: </strong>CMR imaging of left atrial epicardial adipose tissue was performed using fat-water separation Dixon-based sequences in 58 patients (mean age 68.2 ± 10.1 years) presenting for primary pulmonary vein isolation (PVI). Additionally, left atrial volume index (LAVi) was derived from contrast-enhanced angiography. Left atrial epicardial volume index (LA-EATVi) was a significant predictor of LVZ, with significantly higher volumes in LVZ + patients (mean difference of 7.2 ± 2.4 ml/m²), a moderate correlation (r = 0.37, p < 0.001), and a univariate predictive ability with an area under the curve (AUC) of 0.71. Expanding the prediction model with age, gender, and LAVi improves the prediction of LVZ up to an AUC of 0.91. Cutoff selection at 0.25 predicted probability identifies a low-risk group for LVZ, with a negative predictive value of 96.7%, sensitivity 95%, and specificity 76.3%.</p><p><strong>Conclusion: </strong>The pre-procedural identification of a low risk of atrial cardiomyopathy is important to select patients for single-shot catheter ablation. LA-EATVi proved to be of additive value to known risk factors for the prediction of LVZ in a combined prediction model. Patients not considered low risk could be offered an electroanatomic atrial mapping for LVZ detection with the possibility of an LVZ-based radiofrequency ablation approach. Individualized matching of patient and ablation technique using an LVZ prediction model might lead to improved ablation outcomes.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945406","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: \"Cocaine-induced acute myocardial infarction: angiographic features and outcomes\".","authors":"Syeda Samia Fatima, Maha Faraz, Syed Muhammad Ahmed, Ayesha Amin","doi":"10.1007/s00392-025-02750-0","DOIUrl":"https://doi.org/10.1007/s00392-025-02750-0","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945387","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":"Cryptogenic stroke, left atrial function, and atrial fibrillation: a complex relationship.","authors":"Francesca Augusta Gabrielli, Gianluigi Bencardino, Antonio Di Renzo, Serena Abruzzese, Francesca Colò, Pasquale Alessandro Festa, Lorenzo Severo, Federico Ballacci, Gaetano Antonio Lanza, Antonella Lombardo, Gemma Pelargonio, Aldobrando Broccolini","doi":"10.1007/s00392-025-02743-z","DOIUrl":"https://doi.org/10.1007/s00392-025-02743-z","url":null,"abstract":"<p><strong>Background: </strong>Paroxysmal atrial fibrillation (AF) may underlie some embolic strokes of undetermined source (ESUS), but the widespread use of loop recorders (LRs) to detect it may not be cost-effective. This study evaluated whether assessing left atrial (LA) function by speckle tracking echocardiography (STE) could help to identify ESUS patients most likely to benefit from LR monitoring for AF detection.</p><p><strong>Methods: </strong>Consecutive ESUS patients diagnosed between 2020 and 2023, who underwent LR implantation and comprehensive echocardiographic evaluation, including STE, were enrolled. Patients were divided into two groups based on AF detection by LR over a median follow-up of 10.0 months (IQR 6.0-21.7).</p><p><strong>Results: </strong>A total of 64 patients were included: 27 (42.2%) with AF (AF group) and 37 (57.8%) without AF (No-AF group). Compared to the No-AF group, patients in the AF group showed a significantly larger left atrial volume index (LAVi: 44.7 ± 10.8 vs. 34.4 ± 8.3 mL/m²; p < 0.001), a lower LA longitudinal strain of reservoir (LASr: 19.7 ± 8.9% vs. 27.4 ± 9.5%; p = 0.003) and contraction (LASct: 7.4 ± 6.5% vs. 12.4 ± 7.2%; p = 0.008), and an increased LA stiffness index (LASi: 0.6 ± 0.3 vs. 0.3 ± 0.2; p < 0.001). In multivariable Cox regression analysis, only LAVi and LASct remained independent predictors of AF.</p><p><strong>Conclusions: </strong>LAVi and LASct appear useful and reliable predictors of AF occurrence during follow-up in ESUS patients and may aid in selecting those who are most likely to benefit from LR implantation.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945455","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 sarcoidosis in patients with recurrent ventricular arrhythmias refractory to endocardial ablation.","authors":"Karin Nentwich, Karin Klingel, Elena Ene, Julian Müller, Arthur Berkowitz, Sebastian Barth, Thomas Deneke","doi":"10.1007/s00392-024-02509-z","DOIUrl":"10.1007/s00392-024-02509-z","url":null,"abstract":"<p><strong>Introduction: </strong>The clinical presentation of cardiac sarcoidosis is diverse. Detection of granuloma in histopathological evaluation proves the diagnosis, but endomyocardial biopsy (EMB) is associated with a high sampling error. However, prompt immunosuppressive therapy may significantly affect patient's prognosis. By analyzing our single center cohort of patients with recurrent ventricular arrhythmias (VA) and nonischemic cardiomyopathy after failure of endocardial ablation, we looked for additional markers supporting the diagnosis of cardiac sarcoidosis.</p><p><strong>Method: </strong>In the last 4 years, 135 patients (mean age 49 y, 63% male) were hospitalized for epicardial ventricular arrhythmia (VA) ablation after failure of endocardial ablation. Nineteen patients had either previously received a diagnosis of cardiac sarcoidosis or were newly diagnosed. The mean follow-up time was 4.3 years. The ECG criteria, primary manifestation, histological findings in EMB, history of VT ablation, distribution of scars on MRI, electroanatomical mapping (EAM), PET CT findings, presence of atrial tachycardias, valve disease and comorbidities were analyzed.</p><p><strong>Results: </strong>Six of 19 (32%) patients showed right bundle block; 6 of 19 (32%) had AV nodal disease, including 4 patients with AV-block III; and 14 patients (73%) primarily presented with ventricular arrhythmias (including 3 with cardiac arrest). In all 19 patients cardiac EMB revealed elevated CD68 macrophages and CD3 T lymphocytes, and 7 of 19 were positive for granuloma (36,8%). Six of 6 patients (100%) undergoing PET CT showed acute inflammation. By analyzing the scar distribution, the most common locations were basal anteroseptal, basal inferoseptal, mid inferoseptal, mid inferior and the septal RV/RVOT. (septal substrate in 100%). There was a high correlation between the findings on the MRIs and low voltage in the electroanatomical mapping EAM). All patients received an immunosuppressive therapy. No patient died during follow-up, 1 patient had a high urgent heart transplant after withdrawal of steroid therapy.</p><p><strong>Conclusion: </strong>Chronic untreated inflammation may be the underlying pathophysiology for patients with unspecific cardiomyopathy and recurrent VA refractory to endocardial and epicardial ablation. Septal substrate in the EAM/MRI, elevated CD3 lymphocytes in the EBM and inflammation in the PET CT may indicate the possible diagnosis of cardiac sarcoidosis. Initializing immunosuppressive therapy in patients with this dedicated constellation with should be taken into consideration.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"1176-1184"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072220","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":"Clinical and serological characterization of acute pleuropericarditis suggests an autoinflammatory pathogenesis and highlights risk factors for recurrent attacks.","authors":"Dorothee Kaudewitz, Lukas John, Jan Meis, Norbert Frey, Hanns-Martin Lorenz, Florian Leuschner, Norbert Blank","doi":"10.1007/s00392-024-02390-w","DOIUrl":"10.1007/s00392-024-02390-w","url":null,"abstract":"<p><strong>Purpose: </strong>We describe the manifestations and course of patients with pleuropericarditis (PP). Serum parameters were analyzed to evaluate the contribution of autoimmune and autoinflammatory mechanisms to PP pathogenesis. Finally, we outline risk factors for recurrent PP attacks.</p><p><strong>Methods: </strong>Electronic medical records of the University Hospital Heidelberg were screened for PP diagnosis between the years 2009 and 2021. A total of 164 patients were detected and compared to patients suffering from systemic lupus erythematosus (SLE)-associated PP. Follow-up data were collected until January 2023.</p><p><strong>Results: </strong>In 57.3% of a total of 164 PP cases, no trigger was identified (idiopathic PP). The clinical manifestations were similar in subgroups with different triggers (idiopathic, post-cardiac injury and post-infectious). None of the patients in the idiopathic-PP (i-PP) group fulfilled the diagnostic criteria of an autoimmune disease and the i-PP group could be clearly discriminated by clinical, epidemiological and serological means from the control cohort of SLE-associated PP. After a median follow-up of 1048 days, the majority of PP patients (72.7%) had at least one PP relapse. Univariate analyses showed that CRP, SAA (serum amyloid A), troponin T, NT-BNP and post-cardiac injury were negatively correlated, while the presence of fever and an idiopathic trigger were positively correlated with recurrence of PP. Multivariate analyses showed that fever, an idiopathic trigger and low SAA values were risk factors for PP recurrence.</p><p><strong>Conclusion: </strong>This study highlights that most cases of PP are idiopathic and PP cases with various triggers have an identical clinical phenotype. Our data suggest that the clinical, epidemiological and serological characteristics of idiopathic PP considerably differ from patients with PP caused by autoimmune disease like SLE. We further demonstrate that PP has a high risk of recurrence and identify factors associated with this risk, allowing for a targeted secondary prophylaxis.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"1109-1117"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139734680","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":"Deep cardiac phenotyping by cardiovascular magnetic resonance reveals subclinical focal and diffuse myocardial injury in patients with psoriasis (PSOR-COR study).","authors":"Jan Gröschel, Leonhard Grassow, Edyta Blaszczyk, Kerstin Lommel, Georgios Kokolakis, Robert Sabat, Jeanette Schulz-Menger","doi":"10.1007/s00392-024-02456-9","DOIUrl":"10.1007/s00392-024-02456-9","url":null,"abstract":"<p><strong>Background: </strong>Psoriasis vulgaris (PV) is a chronic inflammatory disorder frequently associated with cardiovascular disease (CVD). This study aims to provide a prospective tissue characterization in patients with PV without major CVD using cardiovascular magnetic resonance (CMR).</p><p><strong>Methods: </strong>Patients with PV underwent laboratory assessment, a 12-lead and 24-h ECG, and a CMR exam at a 1.5-T scanner. Scan protocol included assessment of left (LV) and right (RV) ventricular function and strain analysis, native and post-contrast T1 mapping, T2 mapping and late gadolinium enhancement (LGE).</p><p><strong>Results: </strong>In total, 60 PV patients (median(IQR) age in years: 50.0 (36.0-60.8); 34 men (56.7%)) were recruited and compared to 40 healthy volunteers (age in years: 49.5 (37.3-57.8); 21 men (53.0%)). No differences were found regarding LV and RV function (p = 0.78 and p = 0.75). Global radial and circumferential strains were lower in patients (p < 0.001 and p < 0.001, respectively). PV had higher global T1 times (1001 (982-1026) ms vs. 991 (968-1005) ms; p = 0.01) and lower global T2 times (48 (47-49) ms vs. 50 (48-51) ms; p < 0.001); however, all values were within local reference ranges. Focal non-ischemic fibrosis was observed in 17 (28.3%) PV patients.</p><p><strong>Conclusion: </strong>Deep cardiac phenotyping by CMR revealed subclinical myocardial injury in patients with PV without major CVD, despite preserved LV and RV function. Diffuse and focal fibrosis might be the first detectable signs of adverse tissue remodeling leading to reduced circumferential and radial myocardial deformation. In the background of local and systemic immunomodulatory therapy, no signs of myocardial inflammation were detected. The exact impact of immunomodulatory therapies on the myocardium needs to be addressed in future studies.</p><p><strong>Study registration: </strong>ISRCTN71534700.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"1133-1144"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944137","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}