European Journal of Clinical Investigation最新文献

{"title":"Automatic reorientation algorithm for myocardial perfusion SPECT using segmentation","authors":"Ezequiel Vijande,&nbsp;Roxana Campisi,&nbsp;Luis Eduardo Juarez-Orozco,&nbsp;Roberto Agüero,&nbsp;Ricardo Geronazzo,&nbsp;Mauro Namías","doi":"10.1111/eci.70016","DOIUrl":"https://doi.org/10.1111/eci.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cardiac reorientation is a necessary step in processing myocardial perfusion images. This task usually requires manual intervention and thus introduces intra- and inter-operator variability in the processing workflow that may lead to reduced reproducibility of the results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A deep learning model was trained to perform segmentation of cardiac structures from SPECT images simulated from a real PET/CT dataset. Labels used for training were automatically generated in a semi-supervised fashion by using TotalSegmentator on CT images. Segmentation results from the trained model were used to calculate cardiac landmarks from which the cardiac axes were defined, and reorientation was performed. Automatic reorientation was compared against the manual reorientation defined by three expert nuclear cardiologists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average rotation difference between cardiac axes calculated from predicted segmentations and ground-truth segmentations was <span></span><math>\u0000 <semantics>\u0000 <mrow>\u0000 <msup>\u0000 <mn>5.3</mn>\u0000 <mo>°</mo>\u0000 </msup>\u0000 <mo>±</mo>\u0000 <msup>\u0000 <mn>3.1</mn>\u0000 <mo>°</mo>\u0000 </msup>\u0000 </mrow>\u0000 </semantics></math> on the simulated SPECT test dataset. In real SPECT images, the standard deviation of the angle difference between the automatic method and human experts was lower in all axes and operators compared to the maximum inter-operator standard deviation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The proposed deep learning-based algorithm provides an automatic method to perform cardiac reorientation in myocardial perfusion SPECT images with an error range like the variability between operators and with the advantage of using objective anatomical landmarks for the definition of cardiac axes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":"55 S1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786710","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":"Machine learning in cardiovascular risk assessment: Towards a precision medicine approach","authors":"Yifan Wang,&nbsp;Evmorfia Aivalioti,&nbsp;Kimon Stamatelopoulos,&nbsp;Georgios Zervas,&nbsp;Martin Bødtker Mortensen,&nbsp;Marianne Zeller,&nbsp;Luca Liberale,&nbsp;Davide Di Vece,&nbsp;Victor Schweiger,&nbsp;Giovanni G. Camici,&nbsp;Thomas F. Lüscher,&nbsp;Simon Kraler","doi":"10.1111/eci.70017","DOIUrl":"https://doi.org/10.1111/eci.70017","url":null,"abstract":"<p>Cardiovascular diseases remain the leading cause of global morbidity and mortality. Validated risk scores are the basis of guideline-recommended care, but most scores lack the capacity to integrate complex and multidimensional data. Limitations inherent to traditional risk prediction models and the growing burden of residual cardiovascular risk highlight the need for refined strategies that go beyond conventional paradigms. Artificial intelligence and machine learning (ML) provide unique opportunities to refine cardiovascular risk assessment and surveillance through the integration of diverse data types and sources, including clinical, electrocardiographic, imaging and multi-omics derived data. In fact, ML models, such as deep neural networks, can handle high-dimensional data through which phenotyping and cardiovascular risk assessment across diverse patient populations become much more precise, fostering a paradigm shift towards more personalized care. Here, we review the role of ML in advancing cardiovascular risk assessment and discuss its potential to identify novel therapeutic targets and to improve prevention strategies. We also discuss key challenges inherent to ML, such as data quality, standardized reporting, model transparency and validation, and discuss barriers in its clinical translation. We highlight the transformative potential of ML in precision cardiology and advocate for more personalized cardiovascular prevention strategies that go beyond previous notions.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":"55 S1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786965","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":"Strengthening the reporting of diet item details in feeding studies measuring the dietary metabolome: The DID-METAB core outcome set statement.","authors":"Jessica J A Ferguson, Erin D Clarke, Jordan Stanford, María Gómez-Martín, Tammie Jakstas, Clare E Collins","doi":"10.1111/eci.70030","DOIUrl":"https://doi.org/10.1111/eci.70030","url":null,"abstract":"","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70030"},"PeriodicalIF":4.4,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794808","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":"Fatigue and itch severity in patients with PBC and PSC: Prospective analysis of two large cohorts.","authors":"Beata Kruk, Joanna Raszeja-Wyszomirska, Marcin Krawczyk, Piotr Milkiewicz","doi":"10.1111/eci.70041","DOIUrl":"https://doi.org/10.1111/eci.70041","url":null,"abstract":"<p><p>Primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) are rare liver diseases that significantly impair quality of life (QoL). In this study, we analysed two large cohorts comprising a total of 1267 patients with PBC and PSC, showing that fatigue is a frequent symptom in both conditions, particularly among females. Fatigue was associated with liver function markers (ALP/GGT in PSC) and with cirrhosis (in PBC). It was also often linked to cholestatic pruritus, further compromising QoL.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70041"},"PeriodicalIF":4.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771733","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":"Pulmonary hypertension and associated heart failure: New insights on emerging signalling pathways.","authors":"Rosalinda Madonna, Elisa Montemaggi","doi":"10.1111/eci.70038","DOIUrl":"https://doi.org/10.1111/eci.70038","url":null,"abstract":"<p><p>Pulmonary hypertension associated with left heart disease (PH-LHD) represents the hemodynamic condition at rest resulting from pathologies that affect the left ventricle and/or the left atrium. Among the left heart diseases, heart failure is the most frequent cause of PH. PH-LHD is the most common cause of PH, accounting for 65-80% of diagnoses. Several drugs targeting specific signalling pathways involved in the pulmonary remodelling in PH-LHD, including nitric oxide, MAP kinase and endothelin-1, have been tested in randomized clinical trials (RCTs), with disappointing results in terms of efficacy and safety. Therefore, PH-LHD still remains orphan of specific therapies able to counteract the pre- and post-capillary remodelling of the pulmonary circulation. In this article, we will discuss the pathophysiology and molecular mechanisms of PH-LHD. We will focus on the emerging signalling pathways involved in the pathophysiology of PH-LHD that could suggest novel molecular targets for the treatment of this condition.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70038"},"PeriodicalIF":4.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735647","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":"Afterload mismatch after transcatheter edge-to-edge repair in functional mitral regurgitation: A propensity-score matched analysis.","authors":"Filippo Angelini, Stefano Pidello, Simone Frea, Pier Paolo Bocchino, Alessandro Mandurino Mirizzi, Anna Giulia Pavon, Carolina Montonati, Francesco Giannini, Davide Giovannini, Antonio Mangieri, Bernhard Reimers, Paolo Boretto, Guglielmo Gallone, Veronica Dusi, Elena Cavallone, Ovidio De Filippo, Gabriele Crimi, Giuseppe Tarantini, Claudia Raineri, Giovanni Pedrazzini, Fabrizio D'Ascenzo, Luigi Biasco, Gaetano Maria De Ferrari","doi":"10.1111/eci.70040","DOIUrl":"https://doi.org/10.1111/eci.70040","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter edge-to-edge repair (TEER) for severe functional mitral regurgitation (FMR) in patients with reduced left ventricular ejection fraction (LVEF) may lead to an acute increase in left ventricular afterload, termed afterload mismatch (AM). This study aimed to redefine AM clinically, analyse its determinants, and assess its prognostic impact post-TEER in FMR patients.</p><p><strong>Methods: </strong>A multicenter case-control study was conducted, involving FMR patients with LVEF ≤35% undergoing TEER. AM post-TEER was defined as the acute (within 24 h) need for escalation of inotropic or mechanical circulatory support. Sixty-eight AM cases were compared with 68 propensity-matched patients. Primary endpoints included in-hospital mortality post-TEER and 2-year all-cause mortality.</p><p><strong>Results: </strong>Median age was 68 years, 76% male. Procedural success was achieved in 92% of patients. Proportionate MR was associated with a higher risk of AM (adj-HR 1.6, 95% CI 1.01-2.6, p = .04). Conversely, pretreatment with levosimendan (adj-HR .29, 95% CI .12-.70, p < .01) and higher furosemide dose (adj-HR per furosemide 10 mg increase .86, 95% CI .76-.98, p = .03) were protective. In-hospital mortality was higher in the AM cohort (10% vs. 2%, p = .03), while 2-year mortality rates were similar (34% vs. 20%, p = .09). Multivariable analysis revealed higher AM grades and post-procedural MR as predictors of in-hospital mortality and lack of procedural success for 2-year mortality.</p><p><strong>Conclusions: </strong>Among patients with LVEF ≤35% and severe FMR undergoing TEER, AM was associated with in-hospital mortality but did not impact long-term outcomes. Proportionate MR increased the risk of AM, while pretreatment with levosimendan and higher furosemide doses was protective.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70040"},"PeriodicalIF":4.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729460","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":"Cellular composition and transcriptomics of subcutaneous adipose tissue linked to blood glycated haemoglobin.","authors":"Sara Paulí, Núria Oliveras-Cañellas, José Maria Moreno-Navarrete, Anna Castells-Nobau, Francisco José Ortega, Jose Ignacio Rodriguez-Hermosa, Ernesto Castro, Birong Zhang, You Zhou, Javier Gómez-Ambrosi, Ana Belén Crujeiras, Oriol Alberto Rangel-Zuñiga, Lourdes Garrido-Sanchez, Sara Becerril, María Pardo, Juan Luis Romero-Cabrera, Carolina Gutierrez-Repiso, Marcos C Carreira, Manuel Macias-Gonzalez, Miguel Ángel Martinez-Olmos, Gema Frühbeck, Luisa Maria Seoane, José López-Miranda, Francisco José Tinahones, Carlos Diéguez, Jordi Mayneris-Perxachs, José Manuel Fernández-Real","doi":"10.1111/eci.70033","DOIUrl":"https://doi.org/10.1111/eci.70033","url":null,"abstract":"<p><strong>Objective: </strong>Despite growing evidence, the mechanisms connecting adipose tissue (AT) function to type 2 diabetes (T2DM) remain incompletely understood. A detailed analysis of AT transcriptomes could offer valuable insights into this relationship. Here, we examined gene expression patterns in bulk subcutaneous AT, focusing on biological pathways and cellular composition associated with glycated haemoglobin (HbA1c) levels.</p><p><strong>Methods: </strong>A transcriptomic dataset was obtained from subcutaneous AT samples of 901 adults collected during elective surgical procedures. We characterized cellular composition within subcutaneous AT in association with blood HbA1c levels by performing bulk adipose transcriptomes cell deconvolution analysis. We also conducted differential gene expression and overrepresentation analyses. We validated our cross-sectional study using two independent validation cohorts, performing further downstream analyses.</p><p><strong>Results: </strong>Subcutaneous AT from subjects with increased HbA1c had lower adipocytes, smooth muscle, pericytes and other endothelial cell numbers. Pathways associated with HbA1c levels included cellular senescence and telomere-related pathways and extracellular matrix organisation. We identified the expression of RHO GTPases associated with HbA1c not previously linked to glucose homeostasis, with a possible sexual dimorphism shaped by the obesity state. The findings were confirmed in both longitudinal cohorts. At the gene level, HLA-DR, CCL13, and S100A4 mRNA levels were strongly correlated with HbA1c levels.</p><p><strong>Conclusions: </strong>This study underscores the utility of AT transcriptome analysis in unravelling T2DM complexities. Our findings enhance knowledge of glucose homeostasis' molecular and cellular underpinnings, paving the way for potential therapeutic targets to mitigate the impact of AT dysfunction in metabolic diseases.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70033"},"PeriodicalIF":4.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709257","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":"Serum fibulin-1 levels and target organ damage in patients at high cardiovascular risk: A prospective observational study.","authors":"Hack-Lyoung Kim, Jung Pyo Lee, Jeonghwan Lee","doi":"10.1111/eci.70039","DOIUrl":"https://doi.org/10.1111/eci.70039","url":null,"abstract":"<p><strong>Background: </strong>Fibulin-1, an extracellular matrix protein, is a potential biomarker for cardiovascular disease, but its association with target organ damage (TOD) in high-risk patients remains unclear.</p><p><strong>Methods: </strong>We prospectively analysed 330 patients undergoing invasive coronary angiography (ICA) (mean age, 64.7 ± 10.7 years; female, 37.9%). Blood samples obtained just before invasive coronary angiography (ICA) were stored for subsequent measurement of fibulin-1 levels using an enzyme-linked immunosorbent assay. During index admission, eight TOD parameters (obstructive coronary artery disease, impaired kidney function, increased arterial stiffness, left ventricular hypertrophy, left ventricular diastolic dysfunction and arterial occlusive disease of peripheral arteries) were assessed. Long-term clinical follow-up data on major adverse cardiovascular events (MACE) were also collected.</p><p><strong>Results: </strong>Fibulin-1 levels were significantly higher in patients with multiple TOD compared to those without (506 ± 229 vs. 354 ± 148 mcg/mL; p < .001). Serum fibulin-1 levels increased proportionally with the number of TODs (p < .001). Multivariable analyses identified that each 100 mcg/mL increase in serum fibulin-1 level was significantly associated with an increased risk of multiple TOD, even after adjustment for potential confounders (odds ratio: 1.29-1.45; p < .05). Similarly, each 100 mcg/mL increase in serum fibulin-1 level was associated with a 29% higher incidence of MACE (95% confidence interval, 1.14-1.46; p < .001).</p><p><strong>Conclusions: </strong>Fibulin-1 is strongly associated with the extent of TOD and may serve as a useful biomarker for risk stratification in high-risk patients.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70039"},"PeriodicalIF":4.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718486","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":"The cost of emulated target trials: Is real-world data cheaper than randomized studies?","authors":"Mariana Barosa, Vinay Prasad","doi":"10.1111/eci.70035","DOIUrl":"https://doi.org/10.1111/eci.70035","url":null,"abstract":"","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70035"},"PeriodicalIF":4.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700033","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":"The relationship between excess sodium intake and metabolic syndrome: Worth consideration?","authors":"Baris Afsar, Rengin Elsurer Afsar, Said Mowaffaq, Geetha Maddukuri, Krista L Lentine","doi":"10.1111/eci.70036","DOIUrl":"https://doi.org/10.1111/eci.70036","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of metabolic syndrome (MetS) is increasing worldwide. The change in nutrition and eating patterns contributes partly to this rise. On the other hand, increased sodium intake is common in most of the world. There are some studies showing that increased sodium intake may be associated with MetS.</p><p><strong>Methods: </strong>To provide an overview of the current evidence regarding the relationship between excess sodium/salt intake and MetS, we performed a literature search of PubMed/Medline, Web of Science and Google Scholar until October 2024 to recruit studies examining the relationship between sodium/salt intake and MetS.</p><p><strong>Results: </strong>Our review showed that most but not all cross-sectional studies have shown that excess sodium/salt intake is associated with the presence of MetS. Additionally, few longitudinal studies also demonstrated that excess sodium intake is related with the development of new MetS. These studies are mostly observational, and mechanistic studies explaining underlying mechanisms are lacking. The most correlated components of MetS associated with high salt intake were blood pressure and waist circumference, while the correlations between HDL-C, TG and FG were variable.</p><p><strong>Conclusions: </strong>These findings suggest that excess sodium/salt intake may be a risk factor for the development of MetS.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70036"},"PeriodicalIF":4.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699958","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}