Clinical Research in Cardiology最新文献

{"title":"Causal atlas on comorbidities in cardiomyopathy: a Mendelian randomization study of European ancestry.","authors":"Mengting Sun, Ming Gao, Peng Huang, Manjun Luo, Tingting Wang, Xiaorui Ruan, Kebin Chen, Jiapeng Tang, Ye Chen, Jiabi Qin","doi":"10.1007/s00392-025-02647-y","DOIUrl":"https://doi.org/10.1007/s00392-025-02647-y","url":null,"abstract":"<p><strong>Background: </strong>Cardiomyopathy (CM) is often accompanied by comorbidities that increase the risk of death. Our aim is to explore the causal association between CM and its subtypes and various related comorbidities.</p><p><strong>Methods: </strong>Bidirectional Mendelian randomization (MR) was used to explore the causal association between 39 comorbidities and CM, 13 comorbidities and hypertrophic cardiomyopathy (HCM), 25 comorbidities and dilated cardiomyopathy (DCM), and 13 comorbidities and restrictive cardiomyopathy (RCM). Besides, we explored the causal associations between systolic, diastolic, and pulse pressure with CM and DCM, respectively. MR Mediation analysis was used to explore whether atrial fibrillation (AF) or hypertension was as mediating variable mediating the causal association between each other and CM.</p><p><strong>Results: </strong>By MR analysis, we found that AF (OR = 1.28) and hypertension (OR = 3.58) were associated with an increased risk of CM, and CM was causally associated with an increased risk of heart failure (OR = 1.40). In addition, hypertension was causally associated with a lower risk of DCM (OR = 0.22). The results of the causal association of systolic, diastolic, and pulse pressure with CM and DCM were consistent with the direction of the causal association of hypertension with CM and DCM. Through MR Mediation analysis, we found AF as a mediating factor mediates the causal association between hypertension and CM, with a mediating proportion of about 16.22%.</p><p><strong>Conclusions: </strong>This study is the first to reveal the causal association between certain comorbidities and CM and DCM, and to find possible mediating effects among them.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-pass perfusion imaging using cardiovascular magnetic resonance in patients with various cardiac implantable electronic devices.","authors":"Claudia Meier, Michael Bietenbeck, Maria Theofanidou, Volker Vehof, Philipp Stalling, Dennis Korthals, Bishwas Chamling, Misael Estepa, Patrick Doeblin, Sebastian Kelle, Ali Yilmaz","doi":"10.1007/s00392-025-02636-1","DOIUrl":"https://doi.org/10.1007/s00392-025-02636-1","url":null,"abstract":"<p><strong>Aims: </strong>The number of patients with cardiac implantable electronic devices (CIEDs) is increasing. However, there is limited experience regarding vasodilator-stress cardiovascular magnetic resonance (CMR) and resulting device artifacts on perfusion images. The aim of this study was to determine CMR image quality in patients with different CIED types for CMR-based perfusion stress testing.</p><p><strong>Methods and results: </strong>A total of 156 patients with active CIEDs underwent CMR on a 1.5-Tesla scanner. Both conventional steady-state-free-precession (SSFP) and modified spoiled gradient-echo (sGE) protocols under stress and resting conditions were used to evaluate image artifacts in a 16-segment segment model of the heart. The study group comprised 39% conventional pacemaker (PM), 4% cardiac resynchronization therapy-pacemaker (CRT-P), 38% conventional implantable cardioverter-defibrillator (ICD), 6% cardiac resynchronization therapy-ICD (CRT-D), and 13% subcutaneous ICD (S-ICD) patients. PM-carriers showed only minor image artifacts in both perfusion protocols. Artifacts caused by ICDs were predominantly located in the left-ventricular (LV) inferolateral and anterior segments. S-ICDs showed the highest extent of artifacts with an anterolateral accentuation. The artifact extent was significantly reduced when sGE-based perfusion was used compared to SSFP-based sequences. 69% of the patients received a stress-perfusion protocol, and elective coronary angiography confirmed the presence of coronary stenosis in three cases. No major safety-relevant issues occurred.</p><p><strong>Conclusion: </strong>Myocardial perfusion imaging by CMR is safe and feasible with moderate-to-high image quality in patients with all types of CIEDs, including non-conditional devices, ICDs, and S-ICDs. A sGE-based perfusion protocol should be preferred in patients with left-sided ICDs, CRT-Ds, or S-ICDs.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995688","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 arrhythmia recurrence in idiopathic ventricular fibrillation and early repolarization syndrome.","authors":"Benjamin Rath, Julian Wolfes, Christian Ellermann, Fatih Güner, Felix Wegner, Julia Köbe, Florian Reinke, Philipp Sebastian Lange, Gerrit Frommeyer, Lars Eckardt","doi":"10.1007/s00392-025-02648-x","DOIUrl":"https://doi.org/10.1007/s00392-025-02648-x","url":null,"abstract":"<p><strong>Background: </strong>In about 8% of survivors of sudden cardiac death, no structural or electrical heart disease can be identified. Some of these patients with idiopathic ventricular fibrillation (IVF) present ECG markers of early repolarization (Early Repolarization Syndrome, ERS). The T_peak-T_end interval has been linked to increased arrhythmic risk in different clinical settings, such as Brugada syndrome or hypertrophic cardiomyopathy. As there is limited data about the relationship of T_peak-T_end and arrhythmogenesis in IVF, respectively, its significance in risk stratification in ERS, the aim of this study was to investigate a possible correlation between sustained ventricular arrhythmia (VA) recurrences in these patients and the T_peak-T_end interval.</p><p><strong>Methods and results: </strong>We retrospectively investigated 56 consecutive IVF patients (64.3% male, mean age 37.8 ± 12.9 years) who received an implantable cardioverter-defibrillator for secondary prevention. Markers of early repolarization were present in 32.1% of cases. During a mean follow-up of 41.2 ± 35.8 months, 11 patients (19.6%) received in total 18 adequate ICD-therapies. Patients with VA recurrence showed longer T_peak-T_end compared to arrhythmia-free patients (105 ± 14 ms vs. 91 ± 14 ms, p = 0.03). The combination of prolonged T_peak-T_end (> 90 ms) and an early repolarization pattern was associated with a 12-fold increased risk of recurrent VA (p = 0.002).</p><p><strong>Conclusion: </strong>Prolonged T_peak-T_end was associated with VA recurrence in patients with survived IVF. This correlation was even more pronounced in IVF patients with early repolarization pattern. The T_peak-T_end interval might play a future role in risk stratification of patients with ERS.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968075","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":"Transcatheter edge-to-edge repair in anatomically complex degenerative mitral regurgitation: 3-year outcomes from a real-world registry.","authors":"Nicoleta Nita, Michael Paukovitsch, Dominik Felbel, Matthias Gröger, Dominik Buckert, Mirjam Keßler, Wolfgang Rottbauer","doi":"10.1007/s00392-025-02644-1","DOIUrl":"https://doi.org/10.1007/s00392-025-02644-1","url":null,"abstract":"<p><strong>Background: </strong>Recent developments in transcatheter mitral valve repair (M-TEER) have expanded the indication for the procedure beyond conventional criteria to include patients with anatomically complex degenerative mitral regurgitation (DMR), but long-term outcomes are not well known.</p><p><strong>Aims: </strong>To investigate outcomes by specific anatomical criteria in patients with severe DMR and complex valve anatomy enrolled in the prospective MitraUlm registry.</p><p><strong>Methods: </strong>Clinical and echocardiographic 3-year outcomes of 304 patients with DMR and complex mitral valve anatomy, defined according to the CLASP IID registry criteria, were investigated. Outcomes were analysed separately for specific anatomical complexities.</p><p><strong>Results: </strong>33.5% of patients had ≥ independent significant jets, 12% multisegmental prolapse, 12.3% mitral valve orifice area < 4 cm², 10.9% commissural lesions with wide/multiple jets, and 10.1% large flail. Mitral regurgitation (MR) reduction ≤ 2 was achieved in 93.8% of patients at discharge and in 85.9% at 3-year follow-up. Patients with multisegmental prolapse and commissural lesions with multiple/wide jets had the lowest MR reduction at discharge. Compared to patients treated with MitraClip Generation 1-3, patients treated with MitraClip Generation 4 had significantly better post-procedural MR reduction (MR ≤ 1 in 74.3% vs 50.7%, P < 0.001) and higher 3-year survival rates (80.2% vs 61.6%, Log Rank P = 0.002). Postprocedural MR reduction to MR ≤ 1 was the strongest independent predictor of 3-year survival, whereas the presence of at least two anatomical complexities and elevated post-procedural left atrial pressure predicted 3-year all-cause mortality.</p><p><strong>Conclusions: </strong>In patients with anatomically complex DMR, advances in procedural techniques for M-TEER have allowed successful treatment with sustained MR reduction and improved long-term survival.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955198","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 systematic review and meta-analysis of the use of drug-coated balloon angioplasty for treatment of both de novo and in-stent coronary chronic total occlusions.","authors":"Rajkumar Natarajan, Natasha Corballis, Ioannis Merinopoulos, Vasiliki Tsampasian, Vassilios S Vassiliou, Simon C Eccleshall","doi":"10.1007/s00392-025-02639-y","DOIUrl":"https://doi.org/10.1007/s00392-025-02639-y","url":null,"abstract":"<p><strong>Background: </strong>Modern contemporary percutaneous coronary intervention (PCI) techniques with drug-eluting stents (DES) have high procedural success rates in chronic total occlusion (CTO) but with a high prevalence of repeat revascularization. The use of drug-coated balloons (DCBs) in CTO is an alternative treatment strategy. The evidence for DCBs in CTO is, therefore, of interest, and we provide a structured and comprehensive review of the evidence available in terms of the use of DCBs in CTO, including de novo and in-stent (IS) CTO lesions.</p><p><strong>Objectives: </strong>We conducted a systematic review and meta-analysis on the use of DCBs in the management of coronary CTO.</p><p><strong>Methods: </strong>Electronic databases (PubMed, Embase and Ovid) were systematically searched from inception to April 2024 for DCB CTO studies. A meta-analysis was undertaken using a random-effects inverse-variance method due to heterogeneity. The primary outcome is target lesion revascularization (TLR). Secondary outcomes are major adverse cardiac events (MACE) as a composite of target lesion revascularization (TLR), cardiac death (CD), and any myocardial infarction (MI) including procedural and non-procedural MI, target vessel revascularization (TVR), angiographic outcomes such as late lumen loss (LLL), binary restenosis, and reocclusion.</p><p><strong>Results: </strong>A total of 10 studies consisting of 1,695 patients were systematically reviewed. This showed that late luminal changes in terms of lumen gain and minimal lumen loss were consistently seen in CTO cohorts 7-12 months after DCB treatment. Five studies were included for meta-analysis with 1,474 patients. There were no significant differences in TLR between treatment strategies such as DCB, DES, and hybrid (DES + DCB) in both de novo and IS-CTO populations as follows: DCB vs DES [OR, 0.71; 95% CI 0.49-1.02], DCB vs DES in IS-CTO [OR, 0.78; 95% CI 0.45-1.34], DCB vs Hybrid [OR, 0.96; 95% CI 0.39-1.43], and hybrid vs DES [OR, 0.76; 95% CI 0.15-3.84]. Similar findings were seen with the MACE outcome. A sensitivity analysis showed no difference between the above-mentioned groups in terms of MI, CD, and TVR.</p><p><strong>Conclusion: </strong>The limited initial evidence on DCB in coronary CTO-PCI suggests a safe and effective alternative treatment strategy and suggests RCTs are, therefore, required.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981938","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":"C-reactive protein-to-albumin ratio is associated with mortality after transcatheter tricuspid valve repair.","authors":"Karl Finke, Laura Marx, Jan Althoff, Thorsten Gietzen, Matthieu Schäfer, Jan Wrobel, Philipp von Stein, Jennifer von Stein, Maria Isabel Körber, Stephan Baldus, Roman Pfister, Christos Iliadis","doi":"10.1007/s00392-025-02641-4","DOIUrl":"https://doi.org/10.1007/s00392-025-02641-4","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter tricuspid valve repair (TTVr) is a treatment option for tricuspid regurgitation (TR) in patients with high surgical risk. Given the heterogeneity in clinical benefit, there is a need for markers to assess mortality risk in patients undergoing TTVr. The C-reactive protein (CRP)/albumin ratio (CAR) is a marker of systemic inflammation and reduced nutritional status, which can both occur in TR.</p><p><strong>Methods: </strong>Consecutive patients undergoing TTVr at a tertiary care center were retrospectively analyzed. Serum CRP and albumin were collected at baseline. Intraprocedural success (IS) was defined according to TVARC criteria. The primary outcome of all-cause mortality was assessed up to 2 years after TTVr.</p><p><strong>Results: </strong>A total of 215 patients (69% females, median age 80 years) were identified. IS was achieved in 61% of patients. AUC of CAR for 2-year mortality was 0.695, with an optimal threshold of 1.2945 (Youden index) dividing patients in high CAR (n = 93) and low CAR (n = 122) groups. In the high CAR group, the primary endpoint occurred more frequently (43% vs 15%, p < 0.001) and significantly higher right atrial pressure, worse renal function, and less IS during TTVr were observed. High CAR was independently associated with an increased mortality risk even when adjusted for renal and liver function, right-ventricular function, and procedural failure (HR 2.188; 95%CI 1.2-3.9; p = 0.011).</p><p><strong>Conclusion: </strong>Higher CAR reflects patients with advanced right-heart failure and extracardiac organ damage and is associated with mortality after TTVr. CAR is derived from readily available parameters and may be useful additive to established risk scores.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962502","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":"Is takotsubo syndrome probably an acute coronary syndrome after all?","authors":"John E Madias","doi":"10.1007/s00392-025-02646-z","DOIUrl":"https://doi.org/10.1007/s00392-025-02646-z","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771652","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":"Has COVID-19 led to more sudden cardiac deaths in football?","authors":"Ana Ukaj, Tim Meyer, Florian Egger","doi":"10.1007/s00392-024-02569-1","DOIUrl":"10.1007/s00392-024-02569-1","url":null,"abstract":"<p><strong>Introduction: </strong>It is unclear whether the number of sudden cardiac death (SCD) and survived sudden cardiac arrest (SCA) has increased among football players during the COVID-19 pandemic. This study aims to compare the SCD/SCA burden between the pre-pandemic period and COVID-19 pandemic in football players worldwide.</p><p><strong>Methods: </strong>The COVID-19 pandemic and an equivalent pre-pandemic period (each lasting 1151 days) were analyzed for SCD/SCA by extracting data from the prospective FIFA (Fédération Internationale de Football Association) Sudden Death Registry. Particular focus was placed on cardiac diseases acquired through the novel coronavirus SARS-CoV-2, such as myocarditis and coronary artery disease (CAD), potentially leading to SCD/SCA.</p><p><strong>Results: </strong>There were 454 SCD/SCA (survival rate: 24%) and 380 SCD/SCA (survival rate: 27%) during the pre-pandemic period and COVID-19 pandemic, respectively (p = 0.27). In the pre-pandemic period, out of 191 confirmed and suspected diagnoses, there were 6 (3%) cases of myocarditis and 69 (36%) cases of CAD and during the pandemic out of 136 confirmed and suspected diagnoses, there was 1 (1%) case of myocarditis and 58 (43%) cases of CAD.</p><p><strong>Conclusion: </strong>The burden of SCD/SCA, particularly myocarditis and CAD, in football players worldwide seemingly has not been higher during the COVID-19 pandemic than during a comparable period before.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"492-496"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709389","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":"Renal function and periprocedural complications in patients undergoing left atrial catheter ablation: A comparison between uninterrupted direct oral anticoagulants and phenprocoumon administration.","authors":"Nico Erhard, Fabian Bahlke, Lovis Spitzauer, Florian Englert, Miruna Popa, Felix Bourier, Tilko Reents, Carsten Lennerz, Hannah Kraft, Susanne Maurer, Alexander Tunsch-Martinez, Jan Syväri, Madeleine Tydecks, Marta Telishevska, Sarah Lengauer, Gabrielle Hessling, Isabel Deisenhofer, Marc Kottmaier","doi":"10.1007/s00392-024-02374-w","DOIUrl":"10.1007/s00392-024-02374-w","url":null,"abstract":"<p><strong>Background: </strong>Data regarding uninterrupted oral anticoagulation in patients with chronic kidney disease (CKD) during catheter ablation for left atrial arrhythmias is limited. This study aimed to evaluate the safety and efficacy of periprocedural uninterrupted direct oral anticoagulants (DOAC) compared with uninterrupted phenprocoumon in patients with CKD undergoing left atrial catheter ablation.</p><p><strong>Methods and results: </strong>We conducted a retrospective single-center study of patients who underwent left atrial catheter ablation between 2016 and 2019 with underlying chronic kidney disease (glomerular filtration rate (GFR) between 15 and 45 ml/min). The primary objective of this study was to investigate whether direct oral anticoagulant (DOAC) therapy or warfarin presents a superior safety profile in patients with chronic kidney disease (CKD) undergoing left atrial catheter ablation. We compared periprocedural complications (arteriovenous fistula, aneurysm, significant hematoma (> 5 cm)) and/or bleeding (drop in hemoglobin of >2 g/dl, pericardial effusion, retroperitoneal bleeding, other bleeding, stroke) between patients receiving either uninterrupted DOAC or warfarin therapy. Secondary analysis included patient baseline characteristics as well as procedural data. A total of 188 patients (female n = 108 (57%), mean age 75.3 ± 8.1 years, mean GFR 36.8 ± 6 ml/min) were included in this study. Underlying arrhythmias were atrial fibrillation (n = 104, 55.3%) and atypical atrial flutter (n = 84, 44.7%). Of these, n = 132 patients (70%) were under a DOAC medication, and n = 56 (30%) were under phenprocoumon. Major groin complications including pseudoaneurysm and/or AV fistula occurred in 8.9% of patients in the phenprocoumon group vs. 11.3% of patients in the DOAC group, which was not statistically significant (p = 0.62). Incidence of cardiac tamponade (2.3% vs. 0%; p = 0.55) and stroke (0% vs. 0%) were low in both DOAC and phenprocoumon groups with similar post-procedural drops in hemoglobin levels (1.1±1 g/dl vs 1.1±0.9 g/dl; p = 0.71).</p><p><strong>Conclusion: </strong>The type of anticoagulation had no significant influence on bleeding or thromboembolic events as well as groin complications in this retrospective study. Despite observing an increased rate of groin complications, the uninterrupted use of DOAC or phenprocoumon during left atrial catheter ablation in patients with CKD appears to be feasible and effective.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"452-461"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139520162","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":"Neuroticism and sudden cardiac death: a prospective cohort study from UK biobank.","authors":"Tae-Min Rhee, Kyung-Yeon Lee, JungMin Choi, Eue-Keun Choi, Hyo-Jeong Ahn, So-Ryoung Lee, Seil Oh, Gregory Y H Lip","doi":"10.1007/s00392-023-02289-y","DOIUrl":"10.1007/s00392-023-02289-y","url":null,"abstract":"<p><strong>Objective: </strong>There is a paucity of evidence on the risk of sudden cardiac death (SCD) according to the degree of neuroticism. We sought to evaluate the association between neuroticism and the long-term risk of SCD.</p><p><strong>Methods: </strong>From the UK Biobank nationwide prospective cohort, participants free from previous SCD, ventricular arrhythmias, implantable cardioverter-defibrillator (ICD) insertion, depression, schizophrenia, and bipolar disorder were selected. The 12-item scale of neuroticism measurement (neuroticism score) was categorized into high (≥ 3) and low (< 3) groups. The primary outcome was SCD including ventricular fibrillation (VF) at median 12.6 years of follow-up. The outcomes were compared between the groups using multivariable Cox regression and inverse probability of treatment weighting (IPTW).</p><p><strong>Results: </strong>A total of 377,563 participants (aged 56.5 ± 8.1, 53.1% women) were analyzed. The high neuroticism score group had a significantly lower risk of SCD (adjusted hazard ratio [aHR] = 0.87, 95% confidence interval [CI] 0.79-0.96, P = 0.007; IPTW-adjusted HR [IPTW-HR] 0.87 [0.77-0.97], P = 0.016) than the low neuroticism score group. The effect of a high neuroticism score on the decreased risk of SCD was more prominent in women (IPTW-HR 0.71 [0.56-0.89], P = 0.003) than in men (IPTW-HR 0.93 [0.82-1.07], P = 0.305, P-for-interaction = 0.043). Sex differences were observed among independent predictors for incident SCD, emphasizing the protective role of a high neuroticism score and moderate-to-vigorous physical activity only in women.</p><p><strong>Conclusions: </strong>A high neuroticism score was significantly associated with a lower risk of SCD, particularly in women. Efforts to unveil the causal and mechanistic relationship between personality phenotypes and the risk of SCD should be continued.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"443-451"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10075529","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}