European Journal of Clinical Investigation最新文献

{"title":"A novel echocardiographic parameter considering left ventricular afterload during V-A ECMO support","authors":"Kei Sato,&nbsp;Silver Heinsar,&nbsp;Jonathan Chan,&nbsp;Samia M. Farah,&nbsp;Karin Wildi,&nbsp;Nchafatso G. Obonyo,&nbsp;Keibun Liu,&nbsp;Carmen Ainola,&nbsp;Noriko Sato,&nbsp;Gabriella Abbate,&nbsp;Emily S. Wilson,&nbsp;Mahé Bouquet,&nbsp;Kieran Hyslop,&nbsp;Margaret R. Passmore,&nbsp;Shinichi Ijuin,&nbsp;Sun Kyun Ro,&nbsp;Gabriele Fior,&nbsp;Lucia Gandini,&nbsp;Brooke Lundon,&nbsp;David G. Platts,&nbsp;Jacky Y. Suen,&nbsp;Gianluigi Li Bassi,&nbsp;John F. Fraser","doi":"10.1111/eci.14263","DOIUrl":"10.1111/eci.14263","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Left ventricular stroke work index (LVSWI) and cardiac power index (CPI) account for the haemodynamic load of the left ventricle and are promising prognostic values in cardiogenic shock. However, accurately and non-invasively measuring these parameters during veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is challenging and potentially biased by the extracorporeal circulation. This study aimed to investigate, in an ovine model of cardiogenic shock, whether Pressure-Strain Product (PSP), a novel speckle-tracking echocardiography parameter, (1) can correlate with pressure-volume catheter-based LVSWI and CPI, and (2) can be load-independent during the flow modification of V-A ECMO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nine Dorset-cross ewes (51 ± 4 kg) were included. After cardiogenic shock was induced, full support V-A ECMO (X L/min based on 60 mL/kg/min) commenced. At seven time points during 24-h observation, echocardiographic parameters as well as pressure-volume catheter-based LVSWI and CPI were simultaneously measured with X and following X-1 L/min of ECMO flow. PSP was calculated by multiplying global circumferential strain or global radial strain, and mean arterial pressure, for PSPcirc or PSPrad, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PSPcirc showed a stronger correlation with LVSWI (correlation coefficient, CC = .360, <i>p</i> &lt; .001) and CPI (CC = .283, <i>p</i> &lt; .001) than other echocardiographic parameters. The predictability of PSPcirc for pressure-volume catheter-based LVSWI (AUC .82) and CPI (AUC .80) was also higher than other echocardiographic parameters. No statistically significant differences were identified between the two ECMO flow variations in PSPcirc (<i>p</i> = .558).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A novel echocardiographic parameter, PSP, may non-invasively predict pressure-volume catheter-based LVSWI and CPI in a load-independent manner in a cardiogenic shock supported by V-A ECMO.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":"54 10","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/eci.14263","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141287913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiographic surrogate of left ventricular stroke work in a model of brain stem death donors","authors":"Kei Sato,&nbsp;Louise See Hoe,&nbsp;Jonathan Chan,&nbsp;Nchafatso G. Obonyo,&nbsp;Karin Wildi,&nbsp;Silver Heinsar,&nbsp;Sebastiano M. Colombo,&nbsp;Carmen Ainola,&nbsp;Gabriella Abbate,&nbsp;Noriko Sato,&nbsp;Margaret R. Passmore,&nbsp;Mahe Bouquet,&nbsp;Emily S. Wilson,&nbsp;Kieran Hyslop,&nbsp;Samantha Livingstone,&nbsp;Andrew Haymet,&nbsp;Jae-Seung Jung,&nbsp;Kris Skeggs,&nbsp;Chiara Palmieri,&nbsp;Nicole White,&nbsp;David Platts,&nbsp;Jacky Y. Suen,&nbsp;David C. McGiffin,&nbsp;Gianluigi Li Bassi,&nbsp;John F. Fraser","doi":"10.1111/eci.14259","DOIUrl":"10.1111/eci.14259","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The commonest echocardiographic measurement, left ventricular ejection fraction, can not necessarily predict mortality of recipients following heart transplantation potentially due to afterload dependency. Afterload-independent left ventricular stroke work index (LVSWI) is alternatively recommended by the current guideline; however, pulmonary artery catheters are rarely inserted in organ donors in most jurisdictions. We propose a novel non-invasive echocardiographic parameter, Pressure-Strain Product (PSP), as a potential surrogate of catheter-based LVSWI. This study aimed to investigate if PSP could correlate with catheter-based LVSWI in an ovine model of brain stem death (BSD) donors. The association between PSP and myocardial mitochondrial function in the post-transplant hearts was also evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty-one female sheep (weight 47 ± 5 kg) were divided into two groups; BSD (<i>n</i> = 15), and sham neurologic injury (<i>n</i> = 16). Echocardiographic parameters including global circumferential strain (GCS) and global radial strain (GRS) and pulmonary artery catheter-based LVSWI were simultaneously measured at 8-timepoints during 24-h observation. PSP was calculated as a product of GCS or GRS, and mean arterial pressure for PSP_circ or PSP_rad, respectively. Myocardial mitochondrial function was evaluated following 6-h observation after heart transplantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In BSD donor hearts, PSP_circ (<i>n</i> = 96, rho = .547, <i>p</i> &lt; .001) showed the best correlation with LVSWI among other echocardiographic parameters. PSP_circ returned AUC of .825 to distinguish higher values of cardiomyocyte mitochondrial function (cut-off point; mean value of complex 1,2 O₂ Flux) in post-transplant hearts, which was greater than other echocardiographic parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PSP_circ could be used as a surrogate of catheter-based LVSWI reflecting mitochondrial function.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":"54 10","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/eci.14259","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of the low-density lipoprotein cholesterol goals in secondary cardiovascular prevention","authors":"Maria Garcia-Gil,&nbsp;Lia Alves-Cabratosa,&nbsp;Oriol Cunillera,&nbsp;Jordi Blanch,&nbsp;Ruth Martí-Lluch,&nbsp;Anna Ponjoan,&nbsp;Francesc Ribas-Aulinas,&nbsp;Èric Tornabell-Noguera,&nbsp;Lluís Zacarías-Pons,&nbsp;Gina Domínguez-Armengol,&nbsp;Elizabeth Guzmán,&nbsp;Rafel Ramos","doi":"10.1111/eci.14258","DOIUrl":"10.1111/eci.14258","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The effectiveness of statin treatment to reduce coronary events and mortality has been hardly examined considering goals of LDL-C. We aimed to analyse such association in secondary cardiovascular prevention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective cohort analysis of electronic health records from the SIDIAP database, Catalonia-Spain. Recruitment period was from 2006 to 2017 and study period finished at the end of 2018. We included 54,175 people aged ≥35 years in cardiovascular secondary prevention starting statin treatment. We analysed the association of achieved LDL-C goals after statin initiation with coronary heart disease and all-cause mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean age was 69 years and 20,146 (37.2%) were women. Coronary heart disease occurred in 5687 (10.5%) participants, and 10,676 (19.7%) persons passed away. Median follow-up lasted 5.7 years (interquartile range, 3.4–8.1). The coronary heart disease HRs (95% CI) for the LDL-C goals of 70–100, &lt;70–55 and &lt;55 mg/dL were .86 (.81–.92), .83 (.76–.9) and .8 (.72–.88), respectively. They were .89 (.83–.96) in the group with 30%–40% reduction and .86 (.8–.93) in the groups with 40%–50% and ≥50% reduction. We observed no association with mortality. We observed no relevant differences by sex or age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This population-level retrospective analysis of real-world data observed that treatment with statins is effective to achieve certain LDL-C goals and CHD reduction. The lack of significant difference between LDL-C goals needs confirmation in additional studies with real-world data. The LDL-C target should consider the magnitude of the decrease in coronary events.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":"54 9","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/eci.14258","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141198650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ESCI Newsletter","authors":"","doi":"10.1111/eci.14236","DOIUrl":"10.1111/eci.14236","url":null,"abstract":"&lt;p&gt;Welcome to Barcelona.&lt;/p&gt;&lt;p&gt;On behalf of the Organizing Committee, it is a pleasure to invite you to the&lt;/p&gt;&lt;p&gt;&lt;b&gt;58th Annual Scientific Meeting&lt;/b&gt; of the &lt;b&gt;European Society of Clinical Investigation&lt;/b&gt;, which will be held in the lively city of &lt;b&gt;Barcelona&lt;/b&gt;, Spain, &lt;b&gt;June 5-7, 2024&lt;/b&gt;&lt;/p&gt;&lt;p&gt;Both the whole Council of ESCI and the Local Organisers are committed to offering you a unique scientific event to stay at the forefront of the newest scientific discoveries, connect with peers, and contribute to the collective advancement of medical practice through science.&lt;/p&gt;&lt;p&gt;The &lt;b&gt;Congress Programme&lt;/b&gt;, embraced under the theme &lt;b&gt;\"Connecting the Dots: The Power of Integrative Medicine&lt;/b&gt;\", will feature eight different Symposiums running in parallel to provide a holistic and multidisciplinary overview of human health and disease. The symposium will cover: S1) the pathology and physiology of mitochondria; S2) cardiovascular diseases; S3) endocrinology and metabolism; S4) gut, liver, microbiota and lifestyle interventions; S5) gene, cell therapy, and oncology; S6) reproduction biology; S7) personalised and gender medicine; and, S8) ageing-associated disorders. On top of that, the event will feature keynote lectures from world-renowned scientists, providing our audience with unique insights and perspectives on their areas of expertise. The meeting will also host oral abstract presentations, e-poster sessions, multi-focus plenary sessions, pre-meeting courses for young researchers, a welcome ceremony, the Champions League, and multiple and diverse ESCI grants and attractive awards (visit our website).&lt;/p&gt;&lt;p&gt;The ESCI Annual Scientific Meeting aims to bring together outstanding and distinguished speakers from diverse disciplines to present and share their knowledge, outline the most recent advances in the scientific and clinical field, and address hot controversial topics.&lt;/p&gt;&lt;p&gt;We look forward to welcoming all worldwide delegates since the ASM serves as an incredible event to exchange ideas, network with your peers and foster collaboration opportunities. On top of that, young investigators will also have the chance to discuss, criticise, and learn while in contact with senior top scientists in different fields.&lt;/p&gt;&lt;p&gt;With its rich cultural heritage and cosmopolitan metropolis open to the sea and mountains, Barcelona provides an ideal backdrop for this intellectually stimulating event.&lt;/p&gt;&lt;p&gt;\u0000 &lt;b&gt;Gemma Vilahur&lt;/b&gt;\u0000 &lt;/p&gt;&lt;p&gt;\u0000 &lt;i&gt;Chair ESCI - Annual Scientific Meeting Barcelona 2024&lt;/i&gt;\u0000 &lt;/p&gt;&lt;p&gt;Dr. Esteller graduated in Medicine from the Universitat de Barcelona, where he also obtained his Ph.D. in molecular genetics. Dr. Esteller was a Postdoctoral Fellow and a Research Associate at Johns Hopkins where he studied DNA methylation and human cancer.&lt;/p&gt;&lt;p&gt;His work was decisive in establishing promoter hypermethylation of tumor suppressor genes as a common hallmark of cancer.&lt;/p&gt;&lt;p&gt;From October 2001 to Sept","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":"54 S1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/eci.14236","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between blood Pentraxin-3 concentrations and rheumatic diseases: A systematic review and meta-analysis","authors":"Biagio Di Lorenzo,&nbsp;Stefano Zoroddu,&nbsp;Arduino A. Mangoni,&nbsp;Salvatore Sotgia,&nbsp;Panagiotis Paliogiannis,&nbsp;Gian Luca Erre,&nbsp;Ciriaco Carru,&nbsp;Angelo Zinellu","doi":"10.1111/eci.14257","DOIUrl":"10.1111/eci.14257","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Among the Pentraxins, the long Pentraxin-3 (PTX-3) is associated with several processes, particularly in the earliest phases of the innate humoral response. Increased blood PTX-3 concentrations have been observed in a wide range of conditions, from infectious to cardiovascular disorders. Since its increase is more rapid than C-reactive protein (CRP), PTX-3 can be useful to detect and monitor early inflammation. To dissect its pathophysiological role in rheumatic diseases (RD), we conducted a systematic review and meta-analysis comparing blood PTX-3 concentrations in RD patients and healthy individuals and investigating possible associations with clinical, demographic, and study characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a search of published evidence until April 2024 in PubMed, Web of Science and Scopus, which led to the selection of 60 relevant manuscripts from a total of 1072 records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our synthesis revealed a statistically significant difference in PTX-3 concentrations between RD patients and controls (standard mean difference, SMD = 1.02, 95% CI 0.77–1.26, <i>p</i> &lt; .001), that correlated with CRP concentrations. The effect size was associated with geographical region of study conduction, RD type, with a reduction of the observed heterogeneity in patients with low LDL-cholesterol and triglycerides concentrations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study has shown a significant increase in blood PTX-3 concentrations in RD patients, which was associated with specific patient characteristics. Nevertheless, additional studies are needed to better define the utility of measuring PTX-3 in the early phase of RD. Our study was conducted in compliance with the PRISMA 2020 statement (study protocol available at PROSPERO CRD42024516600).</p>\u0000 </section>\u0000 </div>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":"54 10","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New insights into the therapeutic options to lower lipoprotein(a)","authors":"A. Baragetti,&nbsp;L. Da Dalt,&nbsp;G. D. Norata","doi":"10.1111/eci.14254","DOIUrl":"10.1111/eci.14254","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Elevated levels of lipoprotein(a) [Lp(a)] represent a risk factor for cardiovascular disease including aortic valve stenosis, myocardial infarction and stroke. While the patho-physiological mechanisms linking Lp(a) with atherosclerosis are not fully understood, from genetic studies that lower Lp(a) levels protect from CVD independently of other risk factors including lipids and lipoproteins. Hereby, Lp(a) has been considered an appealing pharmacological target.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>However, approved lipid lowering therapies such as statins, ezetimibe or PCSK9 inhibitors have a neutral to modest effect on Lp(a) levels, thus prompting the development of new strategies selectively targeting Lp(a). These include antisense oligonucleotides and small interfering RNAs (siRNAs) directed towards apolipoprotein(a) [Apo(a)], which are in advanced phase of clinical development. More recently, additional approaches including inhibitors of Apo(a) and gene editing approaches via CRISPR-Cas9 technology entered early clinical development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>If the results from the cardiovascular outcome trials, designed to demonstrate whether the reduction of Lp(a) of more than 80% as observed with pelacarsen, olpasiran or lepodisiran translates into the decrease of cardiovascular mortality and major adverse cardiovascular events, will be positive, lowering Lp(a) will become a new additional target in the management of patients with elevated cardiovascular risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":"54 9","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of endogenous GLP-1 on arterial stiffness and renal haemodynamics following bariatric surgery","authors":"D. Moriconi,&nbsp;R. M. Bruno,&nbsp;E. Rebelos,&nbsp;S. Armenia,&nbsp;S. Baldi,&nbsp;L. Bonvicini,&nbsp;S. Taddei,&nbsp;M. Nannipieri","doi":"10.1111/eci.14256","DOIUrl":"10.1111/eci.14256","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cardiovascular trials have revealed the positive impact of GLP-1 receptor agonists (GLP-1 RAs) on cardiovascular outcomes in type 2 diabetes (T2D). However, the specific effects of endogenous GLP-1 on arterial stiffness and renal function remain understudied. This study aimed to explore the influence of endogenous GLP-1 response post-bariatric surgery on arterial stiffness and renal haemodynamic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty individuals with morbid obesity and without T2D, scheduled for Roux-en-Y Gastric Bypass (RYGB), were included. Clinical parameters, 3-hour oral glucose tolerance test (OGTT) with serial sampling for glycaemia, GLP-1 and insulin, carotid-femoral pulse wave velocity (cf-PWV), carotid distensibility coefficient (carotid-DC) and renal resistive index (RRI) measurements were conducted pre-surgery and 1-year post-surgery. Participants were categorized into high-response and low-response groups based on their post-surgery increase in GLP-1 (median increase of 104% and 1%, respectively, pre- vs. post-surgery).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Post-surgery, high-response group demonstrated a greater reduction in cf-PWV (<i>p</i> = .033) and a greater increase (<i>p</i> = .043) in carotid DC compared to low-response group. These enhancements were observed independently of weight loss or blood pressure changes. High-response group exhibited a reduction in RRI (<i>p</i> = .034), although this association was influenced by improvement in pulse pressure. Finally, a multivariate stepwise regression analysis indicated that the percentage increase of GLP1, Δ-GLP1_(AUC)%, was the best predictor of percentage decrease in cf-PWV (<i>p</i> = .014).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Elevated endogenous GLP-1 response following RYGB was associated with improved arterial stiffness and renal resistances, suggesting potential cardio-renal benefits. The findings underscore the potential role of endogenous GLP-1 in influencing vascular and renal haemodynamics independent of traditional weight loss.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":"54 9","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141075742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procedural and clinical outcomes of patients undergoing a TAVI in TAVI procedure: Rationale and design of the multicentre, prospective, observational ReTAVI registry","authors":"Radoslaw Parma,&nbsp;Michael Joner,&nbsp;Francesco Saia,&nbsp;Thomas Cuisset,&nbsp;Victoria Delgado,&nbsp;Josep Rodes-Cabau,&nbsp;Thomas Modine,&nbsp;Eric Van Belle,&nbsp;Luca Nai Fovino,&nbsp;Uri Landes,&nbsp;Hector Alfonso Alvarez-Covarrubias,&nbsp;Mohamed Abdel-Wahab,&nbsp;Jose Luis Zamorano,&nbsp;Matthias Eden,&nbsp;Filippo Cademartiri,&nbsp;Joanna Nawara Skipirzepa,&nbsp;Jana Kurucova,&nbsp;Daniel Greinert,&nbsp;Peter Bramlage,&nbsp;Giuseppe Tarantini","doi":"10.1111/eci.14241","DOIUrl":"10.1111/eci.14241","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Transcatheter aortic valve implantation (TAVI) is increasingly being used in younger patients and those with lower peri-procedural risk, meaning more patients will live long enough to experience structural valve deterioration (SVD) of the bioprosthesis, indicating repeated TAVI. Experience of repeated TAVI—transcatheter heart valve (THV) implantation into an index THV is limited. This registry aims to assess the peri-procedural and short-term safety, efficacy and durability of repeated TAVI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The ReTAVI Prospective observational registry is an investigator-initiated, multicentre, international, prospective registry of patients undergoing repeated TAVI using balloon-expandable SAPIEN prosthesis to evaluate procedural and short-term safety, efficacy and durability as well as anatomical and procedural factors associated with optimal results. The registry will enrol at least 150 patients across 60 high-volume centres. Patients must be ≥18 years old, have had procedural success with their first TAVI, have index THV device failure, intend to undergo repeated TAVI and be considered suitable candidates by their local Heart Team. All patients will undergo a 30-day and 12-month follow-up. The estimated study completion is 2025.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The registry will collect pre-, peri-, postoperative and 12-months data on patients undergoing repeated TAVI procedures with THVs for failure of the index THV and determine VARC-3-defined efficacy and safety at 30 days and functional outcome at 12 months. The registry will expand existing data sets and identify patient characteristics/indicators related to complications and clinical benefits for patients with symptomatic severe calcific degenerative aortic stenosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":"54 9","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/eci.14241","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of revascularization in CTO patients based on hibernating myocardium therapy","authors":"Wenjie Chen,&nbsp;Zhiyong Du,&nbsp;Yanwen Qin,&nbsp;Ze Zheng,&nbsp;Jinghua Liu,&nbsp;Yuchen Shi","doi":"10.1111/eci.14237","DOIUrl":"10.1111/eci.14237","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The effectiveness of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) is still uncertain, especially for patients with ischemic left ventricular dysfunction. This study aimed to assess hibernating myocardium (HM), as determined by single-photon emission computed tomography (SPECT) and ¹⁸F-FDG positron emission tomography (PET), and to compare the benefits of PCI and optimal medical therapy (OMT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective study collected data from 332 patients with CTO and ischemic left ventricular dysfunction. The study compared patients who underwent PCI or OMT via propensity score matching (PSM) analysis which was performed with a 1:2 matching protocol using the nearest neighbour matching algorithm. The primary endpoint of the study was the occurrence of major adverse cardiac events (MACE), defined as a composite of cardiac death, readmission for worsening heart failure (WHF), revascularization and myocardial infarction (MI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After PSM, there were a total of 246 individuals in the PCI and OMT groups. Following Cox regression, hibernating myocardium/total perfusion defect (HM/TPD) was identified as an independent risk factor (hazard ratio (HR): 1.03, 95% confidence interval (CI): 1.008–1.052, <i>p</i> = .007). The cut-off value of HM/TPD was 38%. The results of the subgroup analysis suggest that for patients with HM/TPD &gt;38%, the OMT group had a greater risk of MACE (<i>p</i> = .035). A sensitivity analysis restricting patients with single-vessel CTO lesions, HM/TPD remained an independent predictor (HR 1.025, 95% CI 1.008–1.043, <i>p</i> = .005).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HM/TPD is an independent predictor of MACE, and for patients with HM/TPD &gt; 38%, CTO-PCI had a lower risk of MACE compared with OMT. However, further validation is still needed through large-scale studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":"54 9","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140956910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dutch cardio-oncology cohort: Incident cardiovascular disease predisposes to a higher cancer mortality rate","authors":"Yvonne Koop,&nbsp;Laura Yousif,&nbsp;Rudolf A. de Boer,&nbsp;Michiel L. Bots,&nbsp;Wouter C. Meijers,&nbsp;Ilonca Vaartjes","doi":"10.1111/eci.14255","DOIUrl":"10.1111/eci.14255","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cardiovascular disease (CVD) and cancer are the two leading causes of death worldwide. Given their high prevalence, it is important to understand the disease burden of cancer mortality in CVD patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to evaluate whether patients with incident CVD have a higher risk of malignancy-related mortality, compared to the general population without CVD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a national population-based cohort study selecting patients with incident CVD in the Netherlands between 01 April 2000 and 31 December 2005. A reference cohort was selected from the Dutch population using age, sex and ethnicity. Mortality follow-up data were evaluated after data linkage of national registries from Statistics Netherlands until 31 December 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 2,240,879 individuals were selected with a mean follow-up of 12 years (range 0.4–21.0), of which 738,666 patients with incident CVD with a mean age of 71 ± 15 years. Malignancy mortality per 1000 person years was 84 for the reference group and 118 for patients with CVD, with the highest rate of 258 in patients with heart failure. Patients with CVD had a higher malignancy mortality risk, compared to the reference group: HR 1.35 (95%CI 1.33–1.36). Highest risks were observed in patients with venous diseases (HR 2.27, 95%CI 2.17–2.36) and peripheral artery disease (HR 1.87, 95%CI 1.84–2.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Results show that CVD predisposes to a higher cancer mortality rate. Of all CVD subtypes, HF patients have the highest cancer mortality rate and the hazards were highest in patients with venous diseases and peripheral artery disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":"54 9","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/eci.14255","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140956909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}