Clinical Research in Cardiology最新文献

{"title":"Comment on the CORRECT RADIAL trial: considerations on methodology and interpretation.","authors":"Kristian Rivera, Paula Vela Martín, Juan Casanova-Sandoval","doi":"10.1007/s00392-026-02927-1","DOIUrl":"https://doi.org/10.1007/s00392-026-02927-1","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764681","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":"Real-time three-dimensional systolic dyssynchrony index predicts pacing-induced left ventricular dysfunction and cardiomyopathy.","authors":"Moustafa Dawood, Hoda Abdelgawad, Aly Aboelhoda, Moataz Zaki","doi":"10.1007/s00392-026-02921-7","DOIUrl":"https://doi.org/10.1007/s00392-026-02921-7","url":null,"abstract":"<p><strong>Background: </strong>Right ventricular pacing leads to left ventricular (LV) dyssynchrony, which is a critical factor in the pathophysiology of pacing-induced LV dysfunction (PIVD) and cardiomyopathy (PICM).</p><p><strong>Objectives: </strong>This study aimed to determine the incidence of PIVD and PICM and evaluate the prognostic value of the real-time three-dimensional echocardiography (RT3DE)-derived systolic dyssynchrony index (SDI), measured shortly after pacemaker implantation, in predicting their development.</p><p><strong>Methods: </strong>In this prospective observational study, 108 patients undergoing permanent RV pacing. Only 60 patients with preserved baseline LV ejection fraction (LVEF ≥ 50%) were enrolled. Comprehensive echocardiography, including global longitudinal strain (GLS) and RT3DE for SDI (Tmsv 16-SD) calculation, was performed at baseline, 7-10 days, and 6 months post-implantation. Patients were classified at 6 months as preserved (LVEF reduction ≤ 10%, final LVEF ≥ 50%), PIVD (LVEF reduction > 10%, final LVEF ≥ 50%), or PICM (LVEF reduction > 10%, final LVEF < 50%).</p><p><strong>Results: </strong>The patients' mean age was 62.4 ± 16.3 years, 32 patients were males (53.3%). Mean follow-up was 6.53 ± 0.75 months. Twenty-five patients (41.7%) developed LV impairment; of them, 16 (85%) patients had PIVD, and nine (15%) patients had PICM. While baseline characteristics were similar, the dysfunction group exhibited significantly higher SDI and worse GLS as early as 7-10 days post-pacing. At 6 months, there were significant differences between the preserved group (35 patients) and impaired LV group regarding LV EF (63.6 ± 5 vs. 49.8 ± 11.6, p < 0.001), GLS (- 15.6 ± 3 vs. - 10.9 ± 3.8, p < 0.001), SDI% (2.4 ± 1.2 vs. - 7.9 ± 5.9, p < 0.001), and excursion (5.8 ± 2.23 vs. 3.2 ± 2.1, p < 0.001). In multivariate analysis, both SDI (odds ratio [OR], 5.38; 95% CI, 1.56-18.52; p = 0.008) and GLS (OR, 1.39; 95% CI, 1.02-1.90; p = 0.040) at 7-10 days were independent predictors of 6-month dysfunction. Receiver operating characteristic analysis showed that an SDI > 1.49% predicted dysfunction with an area under the curve of 0.843 (84% sensitivity, 71% specificity). A clear gradient of worsening SDI and GLS was observed from Preserved to PIVD to PICM.</p><p><strong>Conclusions: </strong>Mechanical dyssynchrony quantified by RT3DE-derived SDI is a powerful, independent predictor of pacing-induced LV dysfunction, identifiable within the first week after implantation. This early measurement offers a critical opportunity for risk stratification and guided intervention to prevent the progression to overt cardiomyopathy.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764748","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":"Comparison of therapeutic strategies in patients presenting with left atrial thrombus despite oral anticoagulation.","authors":"Tobias Schreiber, Patrick Nagel, Johannes Lucas, Anja Cretnik, Laura Isabel Adler, Verena Tscholl, Ulf Landmesser, Gerhard Hindricks, Anna Sannino, Andi Rroku, Martin Huemer, Philipp Attanasio","doi":"10.1007/s00392-026-02917-3","DOIUrl":"https://doi.org/10.1007/s00392-026-02917-3","url":null,"abstract":"<p><strong>Background: </strong>Left atrial appendage (LAA) thrombus formation is associated with elevated stroke risk and mortality. This study was designed to compare different therapeutic strategies in patients presenting with LAA thrombi despite adequate oral anticoagulation (OAC) therapy.</p><p><strong>Methods: </strong>In this retrospective single-center study, patients with atrial fibrillation (AF) and LAA thrombus despite adequate OAC for more than three weeks were identified. A follow-up transesophageal echo (TEE) was performed at least four weeks after the initial TEE. Thrombus resolution was assessed for each treatment cycle, defined as the interval of OAC therapy between two consecutive TEE examinations.</p><p><strong>Results: </strong>The study included 216 patients who underwent a total of 294 treatment cycles. At baseline, 47% (n = 101) of patients were receiving novel oral anticoagulants (NOACs), while 53% (n = 115) were treated with vitamin-K antagonists (VKAs). Treatment options included switching OAC from VKA to NOAC (n = 18), from NOAC to a different NOAC (n = 14) and from NOAC to VKA (n = 77); or maintaining the same NOAC (n = 28) or VKA (n = 157). Overall, LAA thrombi resolved in 70% (152/216) after a mean follow up time of 130 (SD 195) days). No significant differences regarding resolution rate between the five different anticoagulation strategies were observed (p = 0.866). Multivariate regression analysis identified tricuspid annular plane systolic excursion as independently predictive of LAA thrombus persistence (OR 0.87; 95% CI 0.78-0.98; p = 0.026).</p><p><strong>Conclusion: </strong>This is the largest cohort of patients presenting with LAA thrombi despite adequate OAC. Overall resolution was 70%. Modification of the anticoagulation regimen did not result in higher thrombus resolution rates compared with continuation of the same therapy.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728824","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":"Predicting atrial fibrillation after an acute coronary syndrome: insights from the BACS & BAMI study.","authors":"Jaime Francisco Larre-Guerra, Álvaro Castrillo-Capilla, Macarena Garbayo-Bugeda, Andrea Kallmeyer, Ester Cánovas, María Nieves Tarín, Carmen Cristóbal, Ana Huelmos, Carlos Gutiérrez-Landaluce, José Antonio Esteban Chapel, Junior Senra, María Luisa González Casaus, Joaquín Alonso, Lorenzo López-Bescós, Ignacio Mahíllo, Óscar Lorenzo, José Manuel Rubio-Campal, José Tuñón","doi":"10.1007/s00392-026-02898-3","DOIUrl":"https://doi.org/10.1007/s00392-026-02898-3","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is among the most prevalent arrhythmias. Its onset after an acute coronary syndrome (ACS) is especially notable given the high coronary disease burden. Mineral metabolism, particularly fibroblast growth factor 23 (FGF23), has been linked to cardiovascular outcomes. This study examines whether FGF23, related markers and other variables can predict AF occurrence after an ACS, considering age differences.</p><p><strong>Methods: </strong>Data were obtained from the BACS & BAMI study, including 1189 patients from five Madrid hospitals. Baseline clinical characteristics and laboratory results were recorded. Patients were monitored annually through clinical appointments. Univariate and multivariate Cox analyses were conducted separately for patients aged ≤ 65 and > 65 years, based on CHA2DS2-VA thromboembolic score.</p><p><strong>Results: </strong>Over a follow-up of 5.44 (3.03-7.46) years, 5.5% of patients developed AF. In those ≤ 65 years, FGF23 was an independent predictor of the development of AF (HR 1.37 [1.04, 1.79] per 100-unit rise; p = 0.026). Among patients > 65 years, a history of stroke was associated with a heightened risk (HR 2.75 [1.03, 7.34]; p = 0.044), while beta-blocker therapy appeared to be protective (HR 0.42 [0.23, 0.78]; p = 0.007). Previous AF consistently forecasted recurrence across both groups (HR 11.3 [2.92, 43.6]; p = 0.002 and HR 6.41 [3.13, 13.1]; p < 0.001, respectively).</p><p><strong>Conclusions: </strong>FGF23 seems to be an independent and positive predictor of AF after an ACS in patients ≤ 65 years, whereas in older individuals, beta-blocker therapy emerges as a potential protective measure. These insights may enhance current risk models with age-specific adjustments and encourage more tailored clinical strategies in post-ACS patients.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728810","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":"TAVI in young patients with bicuspid aortic valve stenosis: insight from the international AD-HOC registry.","authors":"Riccardo Gorla, Francesco Sturla, Filippo Pensotti, Andrea Buono, Andrea Zito, Paolo Alberto Del Sole, Barbara Bellini, Nicholas Joseph Montarello, Yusuke Kobari, Chiara De Biase, Giuliano Costa, Mariachiara Calì, Tommaso Fabris, Francesco Putorti, Mauro Massussi, Giulia Costa, Michele Bellamoli, Mario Garcia Gomez, Enrico Giacomin, Andrea Scotti, Greta Cattaneo, Mariano Pellicano, Michele Galasso, Mauro Gitto, Matthias Renker, Pier Pasquale Leone, Giovanni Esposito, Carlo Trani, Mateusz Orzalkiewicz, Francesco Saia, Alfonso Ielasi, Ady Orbach, Nedy Brambilla, Marco Barbanti, Francesco Burzotta, Daniel J Blackman, Carlo Briguori, Karsten Hug, Tobias Rheude, Mao Chen, Ofir Koren, Raj R Makkar, Azeem Latib, Luca Favero, Antonio Mangieri, Marianna Adamo, Marco De Carlo, Ignacio Amat Santos, Diego Maffeo, Didier Tchètchè, Ole De Backer, Giuseppe Tarantini, Matteo Montorfano, Won-Keun Kim, Darren Mylotte, Luca Testa, Francesco Bedogni","doi":"10.1007/s00392-026-02892-9","DOIUrl":"https://doi.org/10.1007/s00392-026-02892-9","url":null,"abstract":"<p><strong>Background: </strong>Evidence regarding transcatheter aortic valve implantation (TAVI) in young (≤ 75 years) low-risk patients with bicuspid aortic valve (BAV) stenosis deemed unsuitable for surgery is scarce.</p><p><strong>Objectives: </strong>To investigate in-hospital and follow-up outcomes in this population compared with older or higher-risk patients.</p><p><strong>Methods: </strong>This retrospective international registry included 980 patients with severe BAV stenosis undergoing TAVI, stratified in: Group I, < 69 years and Society of Thoracic Surgeons predicted mortality (STS-PROM) < 4 (N = 113); Group II, 69-75 years and STS-PROM < 4 (N = 173); Group III, > 75 years or STS-PROM ≥ 4 (N = 694). Endpoints included technical success, 30-day device success and safety, transcatheter heart valve (THV) function during follow-up, survival and freedom from transient ischemic attack (TIA)/stroke or heart failure hospitalization.</p><p><strong>Results: </strong>Technical success was comparable (Group I: 94.7%, Group II: 97.1%, Group III: 94.5%; P = 0.37), as were 30-day device success (P = 0.45) and safety (P = 0.29). Regression analyses revealed stable mean transvalvular gradients over follow-up with no differential temporal trends across groups (P = 0.93), and no association between follow-up time and PVL severity (P = 0.17); younger patients showed lower odds of mild PVL compared with older patients. Severe valve deterioration did not occur in Group I and II, versus 3 cases (0.4%) in Group III. Bioprosthesis valve failure rate remained < 2% and similar across groups (P = 0.53). Freedom from TIA/stroke or heart failure rehospitalization was higher in Group I (91.1%) and II (93.8%) than in Group III (81.0%, P = 0.006).</p><p><strong>Conclusions: </strong>TAVI in young, low-risk BAV patients deemed unsuitable for surgery showed favorable in-hospital outcomes comparable to those of older or higher-risk patients, with stable valve hemodynamics during follow-up.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728790","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":"Hospitalization profiles and complications across ICD and CRT-D implantations in Germany: data from the VIDEO study.","authors":"Tugba Aktemur Oezalp, Kohei Ukita, Thomas Riemer, Jochen Senges, Johannes Brachmann, Thorsten Lewalter, Thomas Deneke, Nicolas Doll, Lars Eckardt, Daniel Steven, Ibrahim Akin, Roland Richard Tilz","doi":"10.1007/s00392-026-02916-4","DOIUrl":"https://doi.org/10.1007/s00392-026-02916-4","url":null,"abstract":"<p><strong>Background: </strong>Implantable cardioverter-defibrillator (ICD) is a cornerstone therapy for the prevention of sudden cardiac death. However, clinical profiles and in-hospital outcomes may differ according to device type-single-chamber ICD, dual-chamber ICD, or cardiac resynchronization therapy defibrillator (CRT-D). This study aimed to compare hospitalization parameters and peri-procedural complications among patients receiving these device types.</p><p><strong>Methods: </strong>We retrospectively analyzed 2,001 consecutive ICD recipients (single-chamber: 815; dual-chamber: 463; CRT-D: 723). Baseline characteristics, intensive care unit (ICU) utilization, procedure-related complications, and discharge outcomes were compared across groups. The main endpoint was defined as major adverse cardiovascular and cerebrovascular events (MACCE), and the second endpoint was defined as an extended MACCE including both MACCE and intensive care unit (ICU) admission.</p><p><strong>Results: </strong>CRT-D recipients were older (67.5 ± 10.4 years, p < 0.01) and had a higher prevalence of comorbidities, including obesity (12.3%, p = 0.03), diabetes mellitus (30.2%, p = 0.04), permanent atrial fibrillation (10.1%, p < 0.01), and chronic kidney disease (31%, p < 0.01), compared with single- and dual-chamber ICD patients. Post-procedural ICU admission was highest in the dual-chamber ICD group (44.5%, p < 0.01), while ICU stay was shortest among CRT-D recipients (median 2.9 days, p < 0.01), who also required mechanical ventilation less frequently (8.7%, p < 0.01). Overall complication rates were lowest in the single-chamber ICD group (7.5%). Compared with single-chamber ICDs, implantation of dual-chamber ICDs was associated with a significantly higher risk of extended MACCE [OR:1.65, (95% CI:1.30-2.09)], whereas CRT-Ds were associated with a significantly lower risk [OR:0.75, (95% CI:0.60-0.94)]. Furthermore, CRT-Ds were associated with a substantially lower extended MACCE risk compared with dual-chamber ICDs [OR: 0.45, (95% CI:0.35-0x\".58)]. Defibrillator type and age emerged as significant predictors of MACCE. For the extended MACCE endpoint, defibrillator type remained a significant predictor, whereas age was not.</p><p><strong>Conclusion: </strong>Despite their older age and higher comorbidity burden, recipients of CRT-D exhibited the lowest incidence of MACCE. Defibrillator type and age were identified as relevant predictors of MACCE in this patient population.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697407","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":"Mechanical thrombectomy improves left ventricular filling in intermediate-high risk pulmonary embolism: the role of ventricular interdependence.","authors":"Felix Alban, Florian André, Theresa Mokry, Christian Erbel, Norbert Frey, Richard Schell","doi":"10.1007/s00392-026-02913-7","DOIUrl":"https://doi.org/10.1007/s00392-026-02913-7","url":null,"abstract":"<p><strong>Background and purpose: </strong>Acute pulmonary embolism (PE) is the third most common acute cardiovascular condition and remains associated with high mortality. To address the need for risk-adapted therapy, new catheter-directed approaches have emerged for patients with severe PE. While clinical benefits have been shown, underlying mechanisms are poorly understood. This study investigated the impact of mechanical thrombectomy using the FlowTriever device in intermediate-high-risk PE on ventricular filling as a key determinant of systemic hypoperfusion.</p><p><strong>Material and methods: </strong>We analysed 26 patients with CT-confirmed intermediate-high-risk PE who underwent mechanical thrombectomy using the FlowTriever device. Only patients with post-interventional cross-sectional imaging were included. Main outcome measures comprised changes in invasively assessed haemodynamic parameters, including pulmonary artery and pulmonary capillary wedge pressures (PAP, PCWP), as well as ventricular septal curvature, three-dimensional biventricular volumes, and Doppler-derived indices of diastolic function.</p><p><strong>Results: </strong>Thrombectomy significantly reduced systolic PAP (baseline 64.4 ± 19.9 mmHg, Δ =  - 13.6 mmHg, p < 0.0001) and PCWP (baseline 21.7 ± 6.9 mmHg, Δ =  - 4.0 mmHg, p < 0.001). Right ventricular (RV) volumes and septal bowing decreased, whereas left ventricular (LV) volumes and transmitral filling parameters improved (E/e', p = 0.0002). Septal curvature strongly correlated with sPAP (r = 0.84) and LV filling pressure (r =  - 0.51 with E/e'), indicating its potential as a surrogate marker linking RV pressure overload to impaired LV diastolic filling.</p><p><strong>Conclusions: </strong>Mechanical thrombectomy in intermediate-high-risk PE not only relieves RV overload but also enhances LV filling by mitigating ventricular interdependence. These findings provide a mechanistic explanation for improved systemic perfusion and warrant confirmation in prospective studies.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687589","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":"Type 1 and type 2 NSTEMI in atrial fibrillation: insights from the HERA-FIB registry.","authors":"Mustafa Yildirim, Christian Salbach, Johannes Dürr, Matthias Mueller-Hennessen, Hugo A Katus, Norbert Frey, Evangelos Giannitsis","doi":"10.1007/s00392-026-02912-8","DOIUrl":"10.1007/s00392-026-02912-8","url":null,"abstract":"<p><strong>Background: </strong>Differentiating type 1 from type 2 non-ST-elevation myocardial infarction (NSTEMI) is clinically challenging, particularly in patients with atrial fibrillation (AF), where the 4th Universal Definition of Myocardial Infarction (UDMI) allows classification based on presumed mechanisms without mandatory coronary angiography. Real-world data from AF cohorts undergoing systematic invasive evaluation remain limited.</p><p><strong>Methods: </strong>Between 2009 and 2020, we analyzed consecutive AF patients admitted with NSTEMI to a tertiary care center. Patients undergoing early coronary angiography were included. Infarct subtypes were adjudicated according to the 4th UDMI incorporating angiographic findings. The primary objective was to determine the prevalence of type 1 and type 2 NSTEMI. The secondary endpoint was a composite of all-cause mortality, myocardial infarction, stroke, or major bleeding.</p><p><strong>Results: </strong>Among 536 eligible patients, 438 (81.7%) underwent coronary angiography. Of these, 312 (71.2%) were classified as type 1 NSTEMI, 100 (22.8%) as type 2 NSTEMI, and 26 (5.9%) as acute myocardial injury. Type 2 NSTEMI was associated with preserved left ventricular function and less extensive coronary artery disease. Over a median follow-up of 2.21 years, composite event rates were 40.1% in type 1 and 36.0% in type 2 NSTEMI. Acute myocardial injury was associated with the highest composite event rate (65.4%) and all-cause mortality (57.7%).</p><p><strong>Conclusions: </strong>In symptomatic AF patients, type 1 NSTEMI predominates and may be underdiagnosed without angiography, which enables accurate classification and timely revascularization. Type 1 and type 2 NSTEMI confer similarly high long-term risk, while acute myocardial injury identifies a particularly high-risk subgroup requiring systematic evaluation and targeted management.</p><p><strong>Trial registration: </strong>Heidelberg Registry of Atrial Fibrillation [HERA‑FIB]; NCT05995561.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688112","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":"T_peak-T_end interval predicts VT inducibility in arrhythmogenic mitral valve prolapse syndrome.","authors":"Benjamin Rath, Julian Wolfes, Christian Ellermann, Fatih Güner, Felix Wegner, Julia Köbe, Florian Reinke, Gerrit Frommeyer, Lars Eckardt","doi":"10.1007/s00392-026-02918-2","DOIUrl":"https://doi.org/10.1007/s00392-026-02918-2","url":null,"abstract":"<p><strong>Background: </strong>Mitral valve prolapse (MVP) is commonly benign, but an arrhythmic phenotype (AMVP) with increased risk for sudden cardiac death has been described. A prolonged T_peak-T_end interval has been association with increased arrhythmic risk in different clinical settings. The aim of this study was to investigate a possible correlation between prolonged T_peak-T_end interval and ventricular tachycardia (VT) inducibility in MVP.</p><p><strong>Methods and results: </strong>Sixty-five patients fulfilling the EHRA criteria of AMVP syndrome underwent programmed ventricular stimulation between 2016 and 2024. Sustained polymorphic VT was induced in 19 patients (29.2%) and was significantly associated with prolonged T_peak-T_end (100.5 ± 10.3 ms vs. 85.1 ± 9.9 ms, p = 0.002) and prolonged T_peak-T_end/QTc (0.24 ± 0.03 vs. 0.2 ± 0.02, p = 0.004).</p><p><strong>Conclusion: </strong>Prolonged T_peak-T_end was associated with VT inducibility in patients with AMVP syndrome, suggesting its potential value as simple ECG-based marker for risk stratification. If T_peak-T_end also correlates with clinical outcome should be investigated in prospective studies.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688104","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 biomarkers in women with high-risk pregnancies: short-term outcomes from the Heidelberg Cardio-Obstetrics Registry.","authors":"Deborah Siry, Ailís Ceara Haney, Philipp Ehlermann, Norbert Frey, Isabel Amber-Rose Hörbrand, Jan Beckendorf","doi":"10.1007/s00392-026-02920-8","DOIUrl":"https://doi.org/10.1007/s00392-026-02920-8","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy leads to profound physiological changes within the cardiovascular system. However, in women with pre-existing or pregnancy-associated cardiovascular disease (CVD) these adaptations may be insufficient and lead to maternal or fetal complications. The prognostic value of cardiac biomarkers such as N-terminal B-type natriuretic peptide (NTproBNP) and high-sensitivity cardiac troponin-T (hscTnT) in this population remains unclear.</p><p><strong>Material and methods: </strong>In this prospective, single-center cohort study, we included women with pre-existing CVD or who developed CVD during pregnancy. Patients were assessed before pregnancy, during each trimester, and in the postpartum period, when feasible. Biomarker trajectories (NT-proBNP, hs-cTnT) were recorded and their association with maternal complications at delivery was evaluated. Diagnostic accuracy was estimated using receiver operating characteristic curves (ROC).</p><p><strong>Results: </strong>67 women were included (median age 33.0 years, IQR 30.0-37.0): 46 patients (73.1%) with pre-existing CVD and 21 patients (31.3%) who developed CVD during pregnancy. 50 women were observed until delivery and in 30 cases (60%) a maternal and/or fetal complication occurred at birth. Peak NT-proBNP demonstrated good discrimination for maternal complications (AUC 0.722; 95% CI 0.552-0.892) with an optimal cut-off of 209 ng/L (sensitivity 72%, specificity 67%, Youden 0.39). Peak hs-cTnT showed good discrimination as well (AUC 0.729; 95% CI 0.568-0.890) with a cut-off of 22.0 pg/mL (sensitivity 55%, specificity 84%, Youden 0.39).</p><p><strong>Discussion: </strong>In this high-risk real-world cohort of pregnant women with CVD, maternal and/or fetal complications at delivery were common. Elevated NT-proBNP-and to a lesser extent hs-cTnT-was associated with higher complication rates and showed potential for improving risk stratification and monitoring. These findings support multidisciplinary surveillance of pregnant women with CVD and warrant further investigation in larger, multicenter studies.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687378","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}