Frontiers in Cardiovascular Medicine最新文献

{"title":"Association between asthma and cardiovascular disease: evidence from the national health and nutrition examination survey 1999-2018.","authors":"Biao Peng, Wenjing Zhao, Fang Wan, Zhonghai Ji, Runkun Luo, Sheng Wang, Anhua Cao, Zhichao Yang, Da Liu, Changchun Tang, Ping Deng","doi":"10.3389/fcvm.2024.1367576","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1367576","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease(CVD) remains a significant global challenge. Asthma, which is characterized by airway hyperresponsiveness and reversible and limited airflow, plays an important role in cardiovascular diseases. This study aimed to investigate the association between asthma and CVD.</p><p><strong>Methods: </strong>This cross-sectional study included demographic, laboratory, and questionnaire data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. CVD included stroke, congestive heart failure, coronary heart disease, and angina. Multiple logistic regression models were used to detect the association between asthma and the prevalence of CVD, adjusting for age, gender, race, education level, body mass index, ratio of family income to poverty, smoking exposure, drinking exposure, diabetes history, hypertension history, chronic obstructive pulmonary disease (COPD) history, and chronic kidney disease (CKD) history. A subgroup analysis was performed to investigate the association between asthma and CVD in different populations.</p><p><strong>Results: </strong>In total, 16,807 participants were included in this study, including 2,446 who reported having asthma. Compared with participants without asthma, the prevalence of stroke in those with asthma was increased by 1.607 times; the prevalence of congestive heart failure was increased by 1.911 times. Asthma significantly increased the prevalence of stroke among participants aged 18-44 years old, with a BMI 18.50-29.99 kg/m², with low education levels, and with a PIR < 1.00. Asthma also increased the prevalence of angina in females, non-Hispanic Blacks, participants aged 45-59 years old, with a BMI ≥ 30.00 kg/m², and with a PIR < 1.00. The prevalence of congestive heart failure was positively associated with asthma in non-Hispanic Whites or Blacks, participants aged ≥45 years old, with a BMI 25.00-29.99 kg/m², with a PIR < 1.00, and with a low or middle education level.</p><p><strong>Conclusion: </strong>Asthma significantly increases the prevalence of stroke, congestive heart failure. Patients with asthma should be monitored for CVD, including stroke and congestive heart failure.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1367576"},"PeriodicalIF":2.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931134","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":"The association between cardiovascular health and obstructive sleep apnea symptoms: findings from NHANES.","authors":"Qian Guo, Dong Dong, Qiang Zhou, Shuman Huang, Xinjie Qiao, Zihan Dang, Xiaowu Wang, Yulin Zhao","doi":"10.3389/fcvm.2024.1466752","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1466752","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between cardiovascular health (CVH) and obstructive sleep apnea (OSA) within the U.S. population.</p><p><strong>Methods: </strong>This study enrolled 12,540 participants aged 20 years and older from the 2007-2008 and 2015-2018 cycles of the National Health and Nutrition Examination Surveys (NHANES). Weighted univariate and multivariate logistic regression were utilized to examine the relationship between CVH and OSA symptoms. Life's Essential 8 (LE 8) metrics was employed to evaluate the CVH status of participants. Identification of OSA symptoms was determined based on a sleep questionnaire. They include (1) how often you snore; (2) how often you snort/stop breathing; or (3) how often you feel overly sleepy during day. Individuals who answered that they snore 3 or more per week; snort/stop breathing 3 or more per week and feel overly sleepy during day 16-30 times per month were classified as having OSA symptoms.</p><p><strong>Results: </strong>Significant inverse associations were observed between LE8 scores and symptoms of OSA after adjusting for covariates. The 95% CI was 0.750 (0.630,0.893) for the moderate CVH group and 0.573 (0.454,0.723) for the high CVH group. Subgroup analyses, stratified by age and gender, highlighted a significant interaction between LE8 scores and OSA symptoms with age (<i>P</i> < 0.0001). Participants under 60 years old in the high CVH group exhibited a reduced likelihood OSA symptoms (OR: 0.470; 95% CI: 0.345,0.641). Restricted cubic splines (RCS) in a multivariate regression analysis showed a non-linear relationship between LE8 score and OSA. Our finding demonstrates a substantial decrease in OSA symptom prevalence with increased LE 8 scores.</p><p><strong>Conclusion: </strong>The results demonstrate a strong inverse correlation between LE8 scores and OSA symptoms. Participants with higher LE8 scores showed a reduced likelihood of experiencing OSA symptoms.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1466752"},"PeriodicalIF":2.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931141","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":"Editorial: The non-neuronal cholinergic system in the cardiovascular system: its influence on the heart, vasculature, and the central nervous system.","authors":"Yoshihiko Kakinuma, Takashi Sonobe, Rajesh Katare","doi":"10.3389/fcvm.2024.1523385","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1523385","url":null,"abstract":"","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1523385"},"PeriodicalIF":2.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931138","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":"Prognostic value of the derived inflammatory marker SIRI in postmenopausal women with coronary artery disease.","authors":"Pengli Yang, Rui Xue, Yuhang Wei, Chenxi Cao, Songcheng Yu, Shanling Peng, Wenjing Zhang, Yunzhe Wang, Yingying Zheng, Gangqiong Liu","doi":"10.3389/fcvm.2024.1418781","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1418781","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to explore the predictive value of the Systemic Inflammatory Response Index (SIRI) for the prognosis of older postmenopausal women with coronary artery disease (CAD).</p><p><strong>Patients and methods: </strong>This retrospective cohort study included 617 postmenopausal female patients aged 50 years or older with a CAD diagnosis confirmed by coronary angiography seen at the First Affiliated Hospital of Zhengzhou University from January 2019 to December 2020. Patients were divided into three groups based on SIRI tertiles. Primary endpoints were all-cause mortality (ACM) and cardiac mortality (CM), and secondary endpoints were major adverse cardiovascular events (MACEs) and major adverse cardiovascular and cerebrovascular events (MACCEs).</p><p><strong>Results: </strong>The frequencies of all adverse outcomes were greater in the high level (third tertile) SIRI group than in the low level (first tertile) SIRI group. Multivariable regression analysis showed that compared to the low level SIRI group, the high level SIRI group had a 1.581-fold greater risk of ACM [hazard ratio (HR) = 2.581, 95% confidence interval (CI): 1.045-6.373, <i>p</i> = 0.040) and a 1.798-fold greater risk of CM (HR = 2.798, 95% CI: 0.972-8.060, <i>p</i> = 0.057). In addition, the risks of MACEs and MACCEs were 62.3% (HR = 1.623, 95% CI: 1.123-2.346, <i>p</i> = 0.01) and 55.8% (HR = 1.558, 95% CI: 1.100-2.207, <i>p</i> = 0.012) greater in the high level SIRI group compared with the low level SIRI group. Kaplan-Meier survival analyses confirmed that the high SIRI level was associated with increased risks of ACM (<i>p</i> = 0.001), CM (<i>p</i> = 0.005), MACEs (<i>p</i> = 0.003), and MACCEs (<i>p</i> = 0.005).</p><p><strong>Conclusion: </strong>This retrospective study demonstrates that the novel derived inflammatory index SIRI can effectively predict the risk of multiple adverse outcomes in postmenopausal women with CAD.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1418781"},"PeriodicalIF":2.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931139","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":"Case Report: A missed diagnosis of cardiac amyloidosis using echocardiography due to immunoglobulin light chain amyloidosis with normal wall thickness in the early stage.","authors":"Xiaohui Li, Tongge Mu, Yangxue Deng, Yu Zhang, Yun Ti, Lei Zhang","doi":"10.3389/fcvm.2024.1331157","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1331157","url":null,"abstract":"<p><strong>Background: </strong>Cardiac amyloidosis (CA) is a challenging diagnosis, particularly when the classic signs, such as increased wall thickness in a non-dilated left ventricle (LV), are absent. This makes the diagnosis more difficult in patients with normal LV wall thickness. We present a case of CA without increased wall thickness and without the characteristic granular sparkling echotexture in a non-dilated LV.</p><p><strong>Case summary: </strong>A 50-year-old female patient presented with worsening breathlessness on exertion, paroxysmal nocturnal dyspnea, oliguria, and lower-extremity edema. Electrocardiography showed low voltage in the limb leads and a pseudoinfarction pattern in the anterior leads. The echocardiographic evaluation revealed a non-dilated LV with normal wall thickness, no granular sparkling echotexture of the myocardium, a mildly dilated left atrium, restrictive filling (grade 3 diastolic dysfunction), and pericardial effusion. A follow-up quantitative echocardiographic study 2 weeks later showed a slight increase in LV wall thickness (still within the normal range), decreased global longitudinal strain, and a relative \"apical sparing\" pattern of longitudinal strain in the apex of the LV. After 1 month, LV wall thickness increased beyond the normal range, and the granular sparkling echotexture became evident. Cardiac amyloidosis was subsequently confirmed by delayed gadolinium enhancement on cardiac magnetic resonance imaging, abnormal serum-free light chain levels, positive serum immunofixation, and an extracardiac biopsy positive for amyloid.</p><p><strong>Discussion: </strong>Patients presenting with normal wall thickness in a non-dilated LV might only be in an early stage of CA. Thus, the diagnosis can be easily overlooked. For smaller individuals, relative wall thickness (RWT) may be a more sensitive indicator for further investigation. In patients presenting with increased RWT, restrictive filling, and pericardial effusion in the absence of other plausible causes, CA should be considered, even in the absence of the classic echocardiographic signs of amyloid deposition. Furthermore, two-dimensional speckle-tracking echocardiography can enhance clinical suspicion of CA and should be recommended as part of the diagnostic workup.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1331157"},"PeriodicalIF":2.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931135","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":"Dyslipidemia and associated factors among adult type two diabetes mellitus patients in Felege Hiywot Refral, Hospital, Bahir Dar, Ethiopia, 2023.","authors":"Zemenu Addis, Ayenew Tega Nega, Robel Demelash Tebeje, Engdaw Asmare, Alemu Bezabih Tegegnie, Workineh Tamir, Tamiru Alene","doi":"10.3389/fcvm.2024.1493447","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1493447","url":null,"abstract":"<p><strong>Background: </strong>Dyslipidemia is a common condition in type two diabetic patients, and it is thought to have a significant role in moderating the cardiovascular risk associated with diabetes. Data on serum lipid profiles in type 2 diabetes patients from Bahir Dar, Ethiopia is limited. This study aimed to evaluate the prevalence of dyslipidemia among adult type 2 diabetes patients and to explore potential contributing factors.</p><p><strong>Method and materials: </strong>A facility-based cross-sectional study was conducted with 354 type 2 diabetes mellitus patients from April 3 to June 4, 2023. Data were collected through the use of structured questionnaires and checklists. The data were entered into EpiData version 4.6 and analyzed using SPSS version 26. Logistic regression was employed to identify variables significantly associated with the outcomes, with a <i>p</i>-value ≤ 0.05 and a 95% confidence interval.</p><p><strong>Results: </strong>A total of 369 individuals with diabetes were approached in this study, resulting in a response rate of 96%. The overall prevalence of dyslipidemia was 61.3% (95% CI: 56.2-66.7). Of those with dyslipidemia, 11% had a single serum lipid abnormality, while 50.3% had a combined serum lipid abnormality. Significant factors associated with dyslipidemia included being over 60 years old (AOR: 2.4, 95% CI: 1.2-5.0), poor fasting blood glucose control (AOR: 2.5, 95% CI: 1.2-5.1), being overweight (AOR: 5.8, 95% CI: 3.2-11), physical inactivity (AOR: 3.4, 95% CI: 1.7-7.0), and being a past alcohol drinker (AOR: 3.1, 95% CI: 1.3-7.4).</p><p><strong>Conclusion: </strong>In the study area, a high prevalence of dyslipidemia was found among diabetic patients. Independent factors associated with dyslipidemia included older age, poor fasting blood glucose control, physical inactivity, a history of alcohol consumption, and being overweight. To address this issue, it is essential to implement preventive measures such as early detection, patient education, dietary monitoring, regular clinical visits, physical exercise, and weight management. These strategies represent the most effective approach to combating dyslipidemia.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1493447"},"PeriodicalIF":2.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931136","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":"Resveratrol promotes cholesterol efflux from dendritic cells and controls costimulation and T-cell activation in high-fat and lipopolysaccharide-driven atherosclerotic mice.","authors":"Linhui Zhang, Haixia Wang, Zishan Wang, Jianyi Xu, Mengyuan Wang, Wenxin Wang, Qiongshan He, Yun Yu, Dongping Yuan, Guirong Bu, Runze Qiu, Jun Long","doi":"10.3389/fcvm.2024.1450898","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1450898","url":null,"abstract":"<p><p>Cholesterol aggregation in dendritic cells (DCs) triggers an inflammatory response and accelerates the development of atherosclerosis (AS). Resveratrol (RES), a natural compound with anti-inflammatory and cholesterol metabolism regulatory properties, has been shown to influence the maturation and inflammatory functions of DCs. However, its relationship with cholesterol metabolism remains unclear. This study aimed to explore the roles of RES in cholesterol metabolism and inflammatory behaviors of DCs in the context of AS. We analyzed the effect of RES on cholesterol efflux from ApoE^-/- bone marrow-derived dendritic cells (BMDCs) using qRT-PCR, Western blot, and cholesterol efflux assays; identified the inflammatory status of RES-treated BMDCs and co-cultured T cells using flow cytometry and ELISA; confirmed the effect of RES on blood lipids, atherosclerotic lesions, cholesterol metabolism, and inflammatory response in high-fat diet and lipopolysaccharide-treated ApoE^-/- mice; and explored the potential targets of RES in regulating inflammatory behavior via molecular docking. The results revealed that RES promotes cholesterol efflux, increases the expression of efflux transporter ABCA1, and decreases liver X receptor alpha (LXRα) expression in response to a decrease in intracellular cholesterol in ApoE^-/- BMDCs. RES also reduced MHC-II⁺ cells and downregulated costimulatory molecule CD80 in BMDCs with decreased IL-6 and increased IL-2 production, and suppressed T-cell activation and modulates IL-22 and IL-10 secretion via BMDCs. Furthermore, we confirmed that RES relieves arterial lesions and regulates blood lipids in ApoE^-/- mice. RES demonstrated ABCA1 upregulation and LXRα downregulation effects in the aorta and regulated costimulation molecules and Th17/Treg cytokines in the spleen. Furthermore, RES showed multiple hydrogen bonding and low binding energy with ABCA1, suggesting that ABCA1 is a potential target of RES to modulate the inflammatory properties of BMDCs. Our study demonstrated that RES regulates cholesterol efflux and inflammatory behavior in BMDCs, contributing to the control of AS progression and offering new insights for managing inflammatory diseases.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1450898"},"PeriodicalIF":2.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931140","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":"ECPR for cardiac arrest caused by abnormal uterine bleeding and coronary vasospasm: a case report.","authors":"Qiping Sheng, Yingjie Wang, Zhiyang Wu, Xiangyang Zhao, Dawei Wu, Zhi Li, Xi Guo","doi":"10.3389/fcvm.2024.1481498","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1481498","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiac arrest during pregnancy is receiving increasing attention. However, there are few reports on cardiac arrest in nonpregnant women caused by abnormal uterine bleeding (AUB). We report a case in which extracorporeal cardiopulmonary resuscitation (ECPR) was used in a patient with cardiac arrest caused by AUB and coronary vasospasm.</p><p><strong>Patient presentation: </strong>A 52-year-old female patient presented to the emergency department because of sudden chest pain, with a history of hypertension, coronary heart disease and AUB for more than half a month. At the initial stage of admission, cardiac arrest occurred after the ECG demonstrated ST-segment elevation in leads II, III and a VF. ECPR was started after traditional cardiopulmonary resuscitation, and coronary angiography was performed with the support of extracorporeal membrane oxygenation (ECMO). The left and right coronary arteries were slender and narrow, which was relieved after the injection of 100 µg nitroglycerine through the left coronary artery. After performing a coronary angiogram, the patient was given long-acting nitrates and calcium channel blockers orally, and her chest pain did not reoccur. The patient was weaned from ECMO support after 4 days.</p><p><strong>Conclusion: </strong>This clinical case highlights the challenges that clinicians face in accurately diagnosing and possibly treating AUB and coronary vasospasm-induced acute myocardial infarction because of its rare occurrence and serious adverse events. ECPR can effectively improve the success rate of cardiopulmonary resuscitation.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1481498"},"PeriodicalIF":2.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931137","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":"The early and mid-term outcomes of acute type A aortic dissection patients with ECMO.","authors":"Qingqing Meng, Hongkai Jiang, Tianbao Li, Shanwen Pang, Chengbin Zhou, Huanlei Huang, Tucheng Sun, Jinlin Wu","doi":"10.3389/fcvm.2024.1509479","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1509479","url":null,"abstract":"<p><strong>Background: </strong>Acute type A aortic dissection (ATAAD) poses significant challenges in cardiovascular management due to its high morbidity and mortality rates. Postcardiotomy cardiogenic shock (PCS) is a severe complication following ATAAD repair that complicates postoperative recovery. Extracorporeal membrane oxygenation (ECMO) has emerged as a potential life-saving intervention in this context, yet the specific outcomes related to ECMO in ATAAD patients remain insufficiently studied.</p><p><strong>Methods: </strong>This retrospective single-center study reviewed the medical records of 479 patients who underwent ATAAD surgery from September 2017 to June 2021. Patients were stratified into those requiring postoperative ECMO support and those who did not. Data collected included demographics, operative details, and postoperative outcomes.</p><p><strong>Results: </strong>Of the cohort, 19 patients (4.0%) required ECMO support. The ECMO group exhibited significantly higher mortality rates (57.9% vs. 5.4%, <i>p</i> < 0.001) and increased complications, including a higher rate of continuous renal replacement therapy (84.2% vs. 24.3%, <i>p</i> < 0.001) and prolonged ICU stays (14.5 days vs. 7.6 days, <i>p</i> = 0.009). Survival analysis demonstrated a stark contrast in 3-year survival rates, with 36.8% for the ECMO group vs. 92.8% for non-ECMO patients (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>ECMO can be a crucial intervention for ATAAD patients suffering from PCS; however, it is associated with significantly higher mortality and complications. Despite lower long-term survival rates compared to non-ECMO patients, ECMO may offer a survival benefit as a salvage therapy. Interpretation is limited by the retrospective single-center design, small ECMO cohort size, and lack of post-discharge quality-of-life data.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1509479"},"PeriodicalIF":2.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931142","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":"Body mass index mediates the association between plasma lipid concentrations and the prevalence of obstructive sleep apnea among US adults: a cross-sectional study.","authors":"Xiao Hu, Jing Xu, Yang Gu","doi":"10.3389/fcvm.2024.1433884","DOIUrl":"10.3389/fcvm.2024.1433884","url":null,"abstract":"<p><strong>Background: </strong>The association between obstructive sleep apnea (OSA) and plasma lipid concentrations is not consistent. This study aimed to investigate the association of plasma lipid concentrations with the prevalence of OSA among US adults, with an additional examination of the mediating effect of body mass index (BMI).</p><p><strong>Methods: </strong>This cross-sectional study included 8,086 individuals who participated in the National Health and Nutrition Examination Survey (NHANES), conducted from 2005 to 2008 and 2015-2018. Multivariable logistic regression analysis was conducted to compute the odds ratios (ORs) and 95% confidence intervals (CIs) for the association between plasma lipid concentrations and the prevalence of OSA. Additionally, subgroup analysis was used to explore the potential interactions. Generalized additive models (GAM) were constructed to evaluate the nonlinear relationships between lipid concentrations and OSA. Furthermore, mediation analysis was performed to assess the potential mediating role of BMI.</p><p><strong>Results: </strong>In the fully adjusted model, when comparing the lowest quartile, the ORs for the prevalence of OSA among participants in the highest quartile were 1.367 (95% CI, 1.107-1.688) for triglyceride and 1.212 (95% CI, 1.004-1.462) for low-density lipoprotein cholesterol (LDL-C). However, total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) were not associated with OSA. Notably, the relationship between triglyceride and OSA differed in the subgroups of gender, race, and body mass index (BMI) (P for interaction <0.05). Furthermore, we discovered an inverted U-shaped association between triglyceride and OSA (inflection point: 0.813 mmol/L). Causal mediation analysis revealed that BMI significantly mediated the relationship between triglyceride and the prevalence of OSA.</p><p><strong>Conclusions: </strong>This study revealed that an elevated level of triglyceride increased the prevalence of OSA, and this effect was potentially mediated through BMI. Lowering triglyceride concentration may help to reduce the prevalence of OSA.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1433884"},"PeriodicalIF":2.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921090","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}