European Journal of Clinical Investigation最新文献

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Mental stress as a trigger of cardiovascular events: A narrative review. 精神压力作为心血管事件的触发因素:一个叙述性回顾。
IF 3.6 3区 医学
European Journal of Clinical Investigation Pub Date : 2025-09-30 DOI: 10.1111/eci.70128
Paolo Raggi
{"title":"Mental stress as a trigger of cardiovascular events: A narrative review.","authors":"Paolo Raggi","doi":"10.1111/eci.70128","DOIUrl":"https://doi.org/10.1111/eci.70128","url":null,"abstract":"<p><strong>Background: </strong>Several mental disorders has been associated with cardiovascular disease (CVD), although stress may have the strongest correlation. In this narrative review, we examine how stress is linked to CVD.</p><p><strong>Results: </strong>Stress can be secondary to multiple factors and it can be imposed on an individual in more or less manifest ways. Psychosocial stress can result from adverse social circumstances such as poverty, racial, gender, religious disparities or discrimination, violence and environmental pollution. Large segments of the population are forced to endure poor working conditions, low food quality, physical and verbal abuse not only in the developing world but also in more flourishing societies as well. Wars that have ignited widely of late are inherently stressful events with potential enduring effects after the conflicts. Isolation and loneliness are growing issues in modern societies and impose a heavy burden of stress. Epidemiological studies have shown that stress is linked to CVD through an increased incidence of traditional risk factors (smoking, hypertension, insulin resistance and obesity). Experimental and laboratory evidence has shown a link between stress and CVD via neuro-endocrine, inflammatory and immune pathways. Patients with prior CV events affected by stress are at higher risk of recurrent events compared to similar patients without stressful conditions.</p><p><strong>Conclusions: </strong>The close association between stress and CVD suggests that interventions to limit the effect of stress may result in a reduced incidence of de novo and recurrent CV events. Physicians should be aware of the importance of screening for stress in patients with CVD. Future efforts should be directed to the development of easily implementable screening tools and targeted interventions within healthcare frameworks.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70128"},"PeriodicalIF":3.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198840","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}
引用次数: 0
The intergenerational effects of low parental socio-economic position on cardiometabolic and inflammatory outcomes: A systematic review and meta-analysis. 父母低社会经济地位对心脏代谢和炎症结果的代际影响:系统回顾和荟萃分析。
IF 3.6 3区 医学
European Journal of Clinical Investigation Pub Date : 2025-09-29 DOI: 10.1111/eci.70125
Juan Carlos Rivillas-García, Emilie Courtin, Eleanor Winpenny, Olaide Adebayo-Clement, Raúl Devia-Rodríguez, Ornella Moreno-Mattar, Paolo Vineis
{"title":"The intergenerational effects of low parental socio-economic position on cardiometabolic and inflammatory outcomes: A systematic review and meta-analysis.","authors":"Juan Carlos Rivillas-García, Emilie Courtin, Eleanor Winpenny, Olaide Adebayo-Clement, Raúl Devia-Rodríguez, Ornella Moreno-Mattar, Paolo Vineis","doi":"10.1111/eci.70125","DOIUrl":"10.1111/eci.70125","url":null,"abstract":"<p><strong>Background: </strong>Evidence on the impacts of parental and early life socio-economic position (SEP) on health outcomes in adulthood remains mixed. This systematic review and meta-analysis investigated the association between low parental SEP and adult cardiometabolic and inflammatory markers in individuals aged 18 years and older.</p><p><strong>Methods: </strong>A systematic search across five databases (EMBASE, Ovid MEDLINE, Cinahl, Global Health and Maternity and Infant Care until January 01, 2022) identified observational studies linking parental SEP with adult cardiometabolic and inflammatory markers. Pooled Standardized Mean Differences (SMD) were estimated using random-effects models. Risk of bias, heterogeneity and publication bias were assessed using the Cochrane tool, subgroup analysis and Egger's test, respectively.</p><p><strong>Results: </strong>The review included 38 studies (12 in meta-analysis, n = 388,674). Findings showed that lower parental SEP was significantly associated with elevated blood pressure (SMD = .30 mmHg; 95% CI: .10, .50; I<sup>2</sup> 94%; n = 5), increased adiposity (SMD = .56; 95% CI: .05, 1.07: I<sup>2</sup> 98%; n = 6), higher C-reactive protein levels (SMD = 1.45 mg/dL; 95% CI: .06, 2.85; I<sup>2</sup> 80%; n = 9), elevated IL-6 (SMD = 2.12 pg./mL; 95% CI: -.72, 4.97; I<sup>2</sup> 100%; n = 4) and higher allostatic load (SMD = .85; 95% CI: .30, 1.40; I<sup>2</sup> 99%; n = 4). No consistent associations were found for glucose or lipid markers. Gender-specific variations were observed.</p><p><strong>Conclusions: </strong>Low parental socio-economic position negatively impacts adult offspring health, manifesting as higher blood pressure, elevated C-reactive protein, increased interleukin-6, greater adiposity and higher allostatic load. Future research should prioritise three critical areas: mechanistic specificity, intersectional pathways and life-course timing and critical period detection.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70125"},"PeriodicalIF":3.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185138","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}
引用次数: 0
PD-L1 expression pattern as predictive factor of biological behaviour in intracranial meningiomas: A single-center retrospective study. PD-L1表达模式作为颅内脑膜瘤生物学行为的预测因素:一项单中心回顾性研究。
IF 3.6 3区 医学
European Journal of Clinical Investigation Pub Date : 2025-09-24 DOI: 10.1111/eci.70124
Gabriele Gaggero, Alessandro Pesaresi, Debora Giunti, Andrea Bianconi, Monica Truffelli, Massimiliano Grassi, Luca Valle, Sharon Duzioni, Paolo Nozza, Mariella Dono, Giorgia Anselmi, Gianluigi Zona, Valerio Vellone, Pietro Fiaschi
{"title":"PD-L1 expression pattern as predictive factor of biological behaviour in intracranial meningiomas: A single-center retrospective study.","authors":"Gabriele Gaggero, Alessandro Pesaresi, Debora Giunti, Andrea Bianconi, Monica Truffelli, Massimiliano Grassi, Luca Valle, Sharon Duzioni, Paolo Nozza, Mariella Dono, Giorgia Anselmi, Gianluigi Zona, Valerio Vellone, Pietro Fiaschi","doi":"10.1111/eci.70124","DOIUrl":"https://doi.org/10.1111/eci.70124","url":null,"abstract":"<p><strong>Background: </strong>Molecular expression of meningiomas has become increasingly important for predicting their biological behaviour. However, the factors influencing tumour recurrence and progression after surgery remain unclear. Recent studies suggest that programmed death-ligand 1 (PD-L1) could be a key predictive and therapeutic factor in these tumours.</p><p><strong>Methods: </strong>This single-center retrospective study included 96 patients who underwent Simpson Grade I resection of intracranial meningiomas between 2001 and 2022. PD-L1 expression was assessed immunohistochemically (clone SP142) and categorized as overall (OE), membranous (mb), granular cytoplasmic (gr) and perinuclear dot-like. Associations with WHO grade, recurrence, mitotic count and Ki-67 index were analysed using univariate and multivariate statistics.</p><p><strong>Results: </strong>118 samples were analysed. Grade 2 meningiomas showed significantly higher mitotic count (4.0 ± 5.5 vs. 1.0 ± 1.0 n/mm<sup>2</sup>, p < .001) and Ki-67 index (7.6 ± 2.1% vs. 3.5 ± .2%, p < .001) than Grade 1. PD-L1 OE (2.0 ± 5.0% vs. .0 ± 1.0%, p < .001), gr (1.0 ± 2.5% vs. .0 ± 1.0%, p < .001) and mb (1.0 ± 1.0% vs. .0 ± .0%, p = .003) expressions were also higher in Grade 2. At recurrence, Grade 1 tumours progressing to Grade 2 showed increased PD-L1 OE (p = .025), gr (p = .024) and mb (p = .037). Multivariate analysis confirmed PD-L1 gr and mb as independent markers of high-grade tumours.</p><p><strong>Conclusions: </strong>Granular cytoplasmic and membranous PD-L1 expression patterns are significantly associated with tumour grade, recurrence and progression, suggesting their potential role as prognostic biomarkers in meningiomas.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70124"},"PeriodicalIF":3.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130451","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}
引用次数: 0
Central nervous system involvement in cardiac amyloidosis: Redefining the heart-brain axis. 心脏淀粉样变涉及中枢神经系统:重新定义心脑轴。
IF 3.6 3区 医学
European Journal of Clinical Investigation Pub Date : 2025-09-23 DOI: 10.1111/eci.70122
Domenico Mario Giamundo, Giuliano Cassataro, Stefano Ministrini, Simon F Stämpfli
{"title":"Central nervous system involvement in cardiac amyloidosis: Redefining the heart-brain axis.","authors":"Domenico Mario Giamundo, Giuliano Cassataro, Stefano Ministrini, Simon F Stämpfli","doi":"10.1111/eci.70122","DOIUrl":"https://doi.org/10.1111/eci.70122","url":null,"abstract":"<p><strong>Background: </strong>Amyloidosis is characterised by the extracellular accumulation of misfolded proteins forming amorphous aggregates called amyloid. Cardiac amyloidosis results from myocardial involvement in systemic amyloidosis, leading to impaired heart function. Besides myocardial involvement, cardiac amyloidosis may also directly and indirectly affect the central nervous system.</p><p><strong>Methods: </strong>This narrative review summarises current evidence about on central nervous system involvement in cardiac amyloidosis and the pathophysiological mechanisms linking heart and brain in the context of this systemic disease.</p><p><strong>Results: </strong>Although the pathophysiological relationship between cardiac amyloidosis and cognitive decline remains poorly understood, central nervous system involvement likely results from the complex interplay of direct amyloid deposition, cerebrovascular changes, and cardiac dysfunction.</p><p><strong>Conclusion: </strong>The growing awareness of cognitive impairment in patients with cardiac amyloidosis highlights the need for further research and supports a multidisciplinary approach in the assessment and management of affected individuals.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70122"},"PeriodicalIF":3.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124201","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}
引用次数: 0
Machine learning-based prediction of atrial fibrillation in patients with atrial high-rate episodes. 基于机器学习的心房颤动高发生率发作患者预测。
IF 3.6 3区 医学
European Journal of Clinical Investigation Pub Date : 2025-09-14 DOI: 10.1111/eci.70121
Amir Askarinejad, Tommaso Bucci, Niloofar Asgharzadeh, Zahra Amirjam, Enrico Tartaglia, Michele Rossi, Yang Chen, Yalin Zheng, Gregory Y H Lip, Majid Haghjoo
{"title":"Machine learning-based prediction of atrial fibrillation in patients with atrial high-rate episodes.","authors":"Amir Askarinejad, Tommaso Bucci, Niloofar Asgharzadeh, Zahra Amirjam, Enrico Tartaglia, Michele Rossi, Yang Chen, Yalin Zheng, Gregory Y H Lip, Majid Haghjoo","doi":"10.1111/eci.70121","DOIUrl":"https://doi.org/10.1111/eci.70121","url":null,"abstract":"<p><strong>Background: </strong>Given the modest performance of available predictive models in estimating the risk of atrial fibrillation (AF) in patients with atrial high-rate episodes (AHREs) detected by cardiac implantable electronic devices (CIEDs), this study explores the potential use of machine learning (ML) algorithms in this context.</p><p><strong>Purpose: </strong>To assess the ability of ML techniques in identifying patients with AHRE at high risk of AF.</p><p><strong>Methods: </strong>In this prospective study, we enrolled patients without a prior history of AF who experienced at least one AHRE episode detected by CIEDs. ML techniques were applied to predict the 1-year risk of developing new-onset AF based on the following variables: age, BMI, sex, smoking, hypertension, diabetes, coronary artery disease, chronic kidney disease, dyslipidaema, history of stroke or transient ischaemic attack, vascular heart disease, left atrial enlargement (LAE) and congestive heart failure.</p><p><strong>Results: </strong>Study population consists of 100 patients (48% male, mean age 66.0 ± 18.0 years), of whom 24 developed AF (24%) after 1-year follow-up. The CatBoost ML model achieved the highest AUC (.857, 95% CI .671-.999) when compared to other ML models and all clinical risk scores. The top four most influential predictors of AF in the CatBoost model were LAE, hypertension, diabetes and age.</p><p><strong>Conclusions: </strong>ML techniques are robust in predicting AF in patients with AHREs. Further validation in larger, independent cohorts is warranted.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70121"},"PeriodicalIF":3.6,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063550","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}
引用次数: 0
OXPHOS complex deficiency in congenital myopathy: A systematic review 先天性肌病中OXPHOS复合物缺乏:一项系统综述。
IF 3.6 3区 医学
European Journal of Clinical Investigation Pub Date : 2025-09-11 DOI: 10.1111/eci.70114
Megan J. du Preez, Maryke Schoonen, Monray E. Williams, Michelle Bisschoff, Francois H. van der Westhuizen
{"title":"OXPHOS complex deficiency in congenital myopathy: A systematic review","authors":"Megan J. du Preez,&nbsp;Maryke Schoonen,&nbsp;Monray E. Williams,&nbsp;Michelle Bisschoff,&nbsp;Francois H. van der Westhuizen","doi":"10.1111/eci.70114","DOIUrl":"10.1111/eci.70114","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Congenital myopathies are inherited neuromuscular disorders characterized by early-onset muscle weakness and distinct histopathological features. Although mitochondrial involvement in congenital myopathy is well recognized in its pathophysiology, oxidative phosphorylation (OXPHOS) complex dysfunction, which is associated with primary mitochondrial diseases (MD), is not. This systematic review aimed to evaluate the prevalence and characteristics of reported OXPHOS complex dysfunction in genetically confirmed congenital myopathy cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic literature search was conducted in PubMed, Scopus and Web of Science. The search strategy was developed according to PRISMA guidelines. Two independent reviewers screened the studies for inclusion. Eligible studies reported genetically confirmed congenital myopathy cases or disease models and included diagnostic OXPHOS complex analyses via enzyme kinetic assays and/or protein/RNA expression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 5841 studies screened, 23 publications (2009–2025) met the inclusion criteria, comprising 45 congenital myopathy cases. OXPHOS complex dysfunction was reported in 78% of these cases, including all human cases where OXPHOS enzymology was performed. Nine congenital myopathy-associated genes were involved in the cases, with <i>RYR1</i> being the most frequent. No definitive genotype–phenotype relationship was established between specific genes and affected complexes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>OXPHOS complex dysfunction in congenital myopathy appears to be more prevalent than previously recognized, challenging the traditional view that associates such dysfunction exclusively with MD. This emerging evidence suggests that mitochondrial involvement in congenital myopathy is not incidental but may represent a meaningful aspect of its pathophysiology. The potential dysregulation of OXPHOS in congenital myopathy has implications for refining diagnostic frameworks for both congenital myopathy and MD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":"55 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/eci.70114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039521","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}
引用次数: 0
Oral anticoagulant therapy for patients with atrial fibrillation on long-term dialysis: A network meta-analysis of 137,574 patients. 长期透析房颤患者口服抗凝治疗:137,574例患者的网络荟萃分析
IF 3.6 3区 医学
European Journal of Clinical Investigation Pub Date : 2025-09-08 DOI: 10.1111/eci.70120
Yao Du, Yuwen Zeng, Sixin Xu, Qiwei Shen, Jinzhu Hu, Gregory Y H Lip
{"title":"Oral anticoagulant therapy for patients with atrial fibrillation on long-term dialysis: A network meta-analysis of 137,574 patients.","authors":"Yao Du, Yuwen Zeng, Sixin Xu, Qiwei Shen, Jinzhu Hu, Gregory Y H Lip","doi":"10.1111/eci.70120","DOIUrl":"https://doi.org/10.1111/eci.70120","url":null,"abstract":"<p><strong>Background: </strong>Patients with atrial fibrillation (AF) with end-stage renal failure on renal replacement therapy are at high risk of stroke and bleeding, but the optimal oral anticoagulation (OAC) strategy is uncertain. To investigate the most effective OAC therapy for patients with AF on long-term dialysis.</p><p><strong>Methods: </strong>PubMed, EMBASE and Web of Science databases were systematically searched from inception to 9 October 2024 to identify relevant studies on OAC strategy for patients with AF on long-term dialysis. The effectiveness outcomes were ischaemic stroke and/or systemic thromboembolism, all-cause mortality and the safety endpoint was major bleeding.</p><p><strong>Results: </strong>The present study encompassed a comprehensive analysis of 33 studies involving a total of 137,574 patients with AF on long-term dialysis. All OACs, including warfarin (hazard ratio [HR], .963; 95% confidence interval [CI], .841-1.104), did not show a statistically significant decrease in the risk of ischaemic stroke and/or systemic thromboembolism compared to no anticoagulant therapy. Only apixaban 5 mg twice daily was associated with a lower risk of all-cause mortality compared to non-OAC use (HR, .671; 95% CI, .490-.919). Dabigatran (HR, 2.140; 95% CI, 1.734-2.642) and phenprocoumon (HR, 2.419; 95% CI, 1.241-4.713) were associated with a significantly higher risk of major bleeding than non-OAC use.</p><p><strong>Conclusions: </strong>All OACs were not associated with a reduced risk of ischaemic stroke and/or systemic thromboembolism in patients with AF on long-term dialysis. Only apixaban 5 mg twice daily was associated with a decrease in all-cause mortality when compared with non-OAC use.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70120"},"PeriodicalIF":3.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014146","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}
引用次数: 0
Influence of medical educational background on the diagnostic quality of ChatGPT-4 responses in internal medicine: A pilot study 医学教育背景对内科ChatGPT-4应答诊断质量的影响:一项初步研究
IF 3.6 3区 医学
European Journal of Clinical Investigation Pub Date : 2025-09-08 DOI: 10.1111/eci.70113
Nicolò Gilardi, Massimo Ballabio, Francesco Ravera, Lorenzo Ferrando, Mario Stabile, Andrea Bellodi, Giovanni Talerico, Benedetta Cigolini, Carlo Genova, Federico Carbone, Fabrizio Montecucco, Christian Bracco, Alberto Ballestrero, Gabriele Zoppoli
{"title":"Influence of medical educational background on the diagnostic quality of ChatGPT-4 responses in internal medicine: A pilot study","authors":"Nicolò Gilardi,&nbsp;Massimo Ballabio,&nbsp;Francesco Ravera,&nbsp;Lorenzo Ferrando,&nbsp;Mario Stabile,&nbsp;Andrea Bellodi,&nbsp;Giovanni Talerico,&nbsp;Benedetta Cigolini,&nbsp;Carlo Genova,&nbsp;Federico Carbone,&nbsp;Fabrizio Montecucco,&nbsp;Christian Bracco,&nbsp;Alberto Ballestrero,&nbsp;Gabriele Zoppoli","doi":"10.1111/eci.70113","DOIUrl":"10.1111/eci.70113","url":null,"abstract":"<p>This pilot study evaluated the influence of medical background on the diagnostic quality of ChatGPT-4's responses in Internal Medicine. Third-year students, residents and specialists summarised five complex NEJM clinical cases before querying ChatGPT-4. Diagnostic ranking, assessed by independent experts, revealed that residents significantly outperformed students (OR 2.33, <i>p</i> = .007); though overall performance was low. These findings indicate that user expertise and concise case summaries are critical for optimising AI diagnostics, highlighting the need for enhanced AI training and user interaction strategies.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":"55 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/eci.70113","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023036","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}
引用次数: 0
Age-related differences in cardiogenic shock secondary to Takotsubo syndrome. Takotsubo综合征继发心源性休克的年龄相关性差异
IF 3.6 3区 医学
European Journal of Clinical Investigation Pub Date : 2025-09-04 DOI: 10.1111/eci.70119
Marco Tomasino, Ravi Vazirani, Jorge Salamanca, Sergio Raposeiras-Roubin, Clara Fernández-Cordón, Miguel Corbí-Pascual, Oscar Vedia, Agustín C Martín-García, Emilia Blanco-Ponce, Manuel Almendro Delia, Alberto Piserra-López, Jaime Francisco Larre Guerra, Francisco Gonzalez-Santorum, Carmen Lluch-Requerey, Marta Guillén-Marzo, Alberto Pérez-Castellanos, Francisco Ridocci-Soriano, Javier Lopez-País, Rut Andrea, Alessandro Sionis, Iván J Núñez-Gil, Aitor Uribarri
{"title":"Age-related differences in cardiogenic shock secondary to Takotsubo syndrome.","authors":"Marco Tomasino, Ravi Vazirani, Jorge Salamanca, Sergio Raposeiras-Roubin, Clara Fernández-Cordón, Miguel Corbí-Pascual, Oscar Vedia, Agustín C Martín-García, Emilia Blanco-Ponce, Manuel Almendro Delia, Alberto Piserra-López, Jaime Francisco Larre Guerra, Francisco Gonzalez-Santorum, Carmen Lluch-Requerey, Marta Guillén-Marzo, Alberto Pérez-Castellanos, Francisco Ridocci-Soriano, Javier Lopez-País, Rut Andrea, Alessandro Sionis, Iván J Núñez-Gil, Aitor Uribarri","doi":"10.1111/eci.70119","DOIUrl":"https://doi.org/10.1111/eci.70119","url":null,"abstract":"<p><strong>Background: </strong>Age-related differences in Takotsubo Syndrome (TTS) have been described, but there is limited information regarding TTS patients who develop cardiogenic shock (CS).</p><p><strong>Methods and results: </strong>We analysed data from 408 CS-TTS patients in the RETAKO registry. Patients were stratified into three age groups: ≤50 years (9%), 51-74 years (48%), and ≥75 years (43%). In the youngest group, compared to the middle-aged and the oldest groups, patients were more likely to be male (35% vs. 16% and 14%, p = .01), have a physical trigger (65% vs. 43% and 49%, p = .04), exhibit atypical echocardiographic patterns (27% vs. 11% and 11%, p = .02), and experienced a higher incidence of ventricular arrhythmias (24% vs. 8% and 7%, p = .01). In-hospital mortality rates were 5% in younger patients, 12% in middle-aged patients, and 15% in older patients (p = .15). Older age independently predicted both in-hospital mortality (OR 2.33, 95% CI 1.05-5.17; reference: middle-aged) and 5-year mortality (HR 3.69, 95% CI 1.77-7.67), regardless of shock severity.</p><p><strong>Conclusions: </strong>In CS-TTS, younger patients exhibit distinct clinical features but have better outcomes. Older age is associated with higher in-hospital and long-term mortality, regardless of comorbidities and shock severity. These findings underscore the need for age-specific management strategies and further research into the mechanisms underlying age-related differences in CS-TTS.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70119"},"PeriodicalIF":3.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991807","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}
引用次数: 0
Response to the comment on ‘Branched-chain amino acids and all-cause mortality in patients with liver cirrhosis, and the onset of diabetes in liver transplant recipients’ 对“肝硬化患者支链氨基酸与全因死亡率及肝移植受者糖尿病发病”评论的回应。
IF 3.6 3区 医学
European Journal of Clinical Investigation Pub Date : 2025-09-03 DOI: 10.1111/eci.70118
Yakun Li, Robin P. F. Dullaart
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