Frontiers in Cardiovascular Medicine最新文献

{"title":"Effect of physical exercise on metabolism in patients with atrial fibrillation.","authors":"Yutong Wang, Sixian Weng, Chenxi Xia, Tao Xu, Xinyang Song, Fang Wang","doi":"10.3389/fcvm.2024.1502620","DOIUrl":"10.3389/fcvm.2024.1502620","url":null,"abstract":"<p><p>Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, is closely linked to metabolic dysfunctions, including obesity, diabetes, and dyslipidemia. These lead to pathological changes in myocardial metabolism and mitochondrial energy metabolism, thereby aggravating AF's incidence and severity. This review introduces the role of metabolic dysfunctions in exacerbating AF, assesses the therapeutic potential of physical exercise and investigates it as a non-pharmacological intervention to alleviate these metabolic disturbances. Evidence suggests that regular physical activity not only enhances metabolic profiles but also reduces the frequency of AF episodes and improves overall cardiovascular health. At the same time, the review emphasizes the need for individualized exercise regimens, individualized to the metabolic and cardiac conditions of each patient to optimize benefits and minimize risks. Additionally, it calls for more basic studies and large-scale clinical trials to establish and refine evidence-based exercise guidelines specific to AF management.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1502620"},"PeriodicalIF":2.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921092","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 potential of inflammatory markers in chronic kidney disease patients combined with acute myocardial infarction.","authors":"Peizhu Dang, Bohan Li, Yongxin Li","doi":"10.3389/fcvm.2024.1430215","DOIUrl":"10.3389/fcvm.2024.1430215","url":null,"abstract":"<p><strong>Background: </strong>Inflammation significantly impacts chronic kidney disease (CKD) and acute myocardial infarction (AMI). This study investigates the prognostic value of inflammatory markers in predicting outcomes for CKD patients with AMI.</p><p><strong>Methods: </strong>We enrolled patients diagnosed with CKD concomitant with AMI, choosing five inflammatory markers related to both diseases. Patients were categorized into elevated inflammatory markers group and control group based on inflammatory markers cut-off values for predicting in-hospital major adverse cardiac and cerebrovascular events (MACCE). Using univariate and multivariate logistic regression, we identified inflammation-related risk factors for MACCE. We adjusted covariates stepwise to explore the relationship between independent risk factors and adverse outcomes. We also evaluated the predictive value of these markers for MACCE by receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>In the multivariate logistic regression analysis, higher levels of neutrophil-to-lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) significantly increased risk of MACCE (all <i>P</i> < 0.05). After adjusting above two indicators, NLR was independently associated with in-hospital MACCE in CKD patients with AMI (OR = 10.764, 95% CI: 1.887-61.406, <i>P</i> = 0.007). Furthermore, compared to other inflammatory markers, NLR had the highest predictive value for MACCE in patients with AMI and CKD [Area Under the Curve (AUC): 0.748, 95% Confidence Interval (CI): 0.634-0.861, <i>P</i> < 0.001].</p><p><strong>Conclusion: </strong>In CKD patients combined with AMI, elevated levels of inflammation markers could increase the risk of MACCE. NLR may provide superior predictive value compared to other markers.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1430215"},"PeriodicalIF":2.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921111","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":"Analyzing the non-linear relationship between fasting blood glucose levels and Gensini score in patients with STEMI.","authors":"Han Li, Quanzhi Lin, Zhiyuan Jiang, Guoqiang Zhong","doi":"10.3389/fcvm.2024.1427567","DOIUrl":"10.3389/fcvm.2024.1427567","url":null,"abstract":"<p><strong>Background: </strong>Acute myocardial infarction (AMI), particularly ST-segment elevation myocardial infarction (STEMI), significantly impacts global health, exacerbated by risk factors such as diabetes mellitus (DM). While the Gensini score effectively quantifies coronary artery lesions, its correlation with fasting blood glucose (FBG) levels, particularly in a non-linear fashion, has not been thoroughly explored in STEMI patients.</p><p><strong>Methods: </strong>This study analyzed data from 464 STEMI patients treated with percutaneous coronary intervention at the First People's Hospital of Taizhou City, Zhejiang Province, China, from January 2010 to October 2014. We stratified patients into three FBG tertiles and utilized multiple statistical analyses, including least absolute shrinkage and selection operator (LASSO) regression and curve fitting, to examine the potential U-shaped relationship between FBG levels and Gensini scores.</p><p><strong>Results: </strong>Our analysis revealed significant differences in Gensini scores across FBG tertiles, with both hypoglycemic and hyperglycemic extremes showing higher scores compared to the normoglycemic range. The curve fitting analysis confirmed a U-shaped relationship, suggesting a significant, non-linear association between FBG levels and coronary artery lesion severity, regardless of diabetes status.</p><p><strong>Conclusions: </strong>Our findings underscore the complexity of glycemic control in STEMI management and suggest that both hypo- and hyperglycemia are significant risk factors for severe coronary lesions as quantified by the Gensini score. This study highlights the importance of comprehensive FBG monitoring and management to improve outcomes for STEMI patients.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1427567"},"PeriodicalIF":2.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921088","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":"Engineering extracellular vesicles for targeted therapeutics in cardiovascular disease.","authors":"Enze Fu, Kai Pan, Zongjin Li","doi":"10.3389/fcvm.2024.1503830","DOIUrl":"10.3389/fcvm.2024.1503830","url":null,"abstract":"<p><p>Extracellular vesicles (EVs) are nanosized particles secreted by cells that play crucial roles in intercellular communication, especially in the context of cardiovascular diseases (CVDs). These vesicles carry complex cargo, including proteins, lipids, and nucleic acids, that reflects the physiological or pathological state of their cells of origin. Multiomics analysis of cell-derived EVs has provided valuable insights into the molecular mechanisms underlying CVDs by identifying specific proteins and EV-bound targets involved in disease progression. Recent studies have demonstrated that engineered EVs, which are designed to carry specific therapeutic molecules or modified to enhance their targeting capabilities, hold promise for treating CVDs. Analysis of the EV proteome has been instrumental in identifying key proteins that can be targeted or modulated within these engineered vesicles. For example, proteins involved in inflammation, thrombosis, and cardiac remodeling have been identified as potential therapeutic targets. Furthermore, the engineering of EVs to increase their delivery to specific tissues, such as the myocardium, or to modulate their immunogenicity and therapeutic efficacy is an emerging area of research. By leveraging the insights gained from multiomics analyses, researchers are developing EV-based therapies that can selectively target pathological processes in CVDs, offering a novel and potentially more effective treatment strategy. This review integrates the core findings from EV multiomics analysis in the context of CVDs and highlights the potential of engineered EVs in therapeutic applications.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1503830"},"PeriodicalIF":2.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921107","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":"Sex differences and clinical outcomes, including ventricular tachyarrhythmias, of patients with heart failure with reduced ejection fraction treated with sacubitril/valsartan.","authors":"Mohammad Abumayyaleh, Carina Krack, Jonathan Demmer, Christina Pilsinger, Tobias Schupp, Michael Behnes, Katherine Sattler, Ibrahim El-Battrawy, Nazha Hamdani, Ibrahim Akin","doi":"10.3389/fcvm.2024.1503414","DOIUrl":"10.3389/fcvm.2024.1503414","url":null,"abstract":"<p><strong>Background: </strong>Women with heart failure with reduced ejection fraction (HFrEF) often experience worse clinical outcomes compared to men, including higher rates of mortality, hospitalization, and congestion. However, the effects of sacubitril/valsartan on these outcomes, as well as on ventricular tachyarrhythmias, have not been well studied in women with HFrEF.</p><p><strong>Methods: </strong>This study included consecutive series of patients treated with sacubitril/valsartan at University Hospital Mannheim from 2016 to 2020. Baseline and follow-up data were compared between women and men. The endpoints included all-cause mortality, ventricular tachyarrhythmias, all-cause hospitalization, and congestion.</p><p><strong>Results: </strong>A total of 246 patients were analyzed, comprising 50 (20.3%) women and 196 (79.7%) men. The study population consisted of 34.3% ambulatory patients and 65.7% hospitalized patients admitted for acute decompensated or symptomatic HF. The sex distribution was as follows: among women, 48.6% were ambulatory and 51.4% were hospitalized, while among men, 30.6% were ambulatory and 69.4% were hospitalized. Ischemic cardiomyopathy (ICM) was less common as a cause of heart failure (HF) in women than in men (32% vs. 57.7%, <i>p</i> = 0.001). During the 12-month follow-up, left ventricular ejection fraction (LVEF) improved more significantly in women than in men, increasing from 29.0% (10.0-45.0) to 40.0% (15.0-59.0) in women (<i>p</i> = 0.009) compared to an increase from 28.0% (3.0-65.0) to 33.0% (13.0-60.0) in men. There were no significant differences in all-cause mortality at 12-month between women and men (4% vs. 6.7%; <i>p</i> = 0.742). The results indicated no significant differences between the sexes in the incidence of ventricular tachyarrhythmias [ventricular fibrillation [VF] and sustained ventricular tachycardia [VT]] (4.5% vs. 0.6%; <i>p</i> = 0.121) (2.3% vs. 3.9%; <i>p</i> = 1.00), hospitalizations (70.2% vs. 67.8%; <i>p</i> = 0.769), congestion at 12-month follow-up (11.4% vs. 10.1%; <i>p</i> = 0.762). Female sex was not identified as a predictor for the occurrence of ventricular tachyarrhythmias or mortality rate at 12 months [hazard ratio (HR), 0.586; 95%-confidence interval (CI) 0.17-2.016; <i>p</i> = 0.397] (HR, 1.898; 95%-CI 0.381-9.464; <i>p</i> = 0.434).</p><p><strong>Conclusion: </strong>Women with HFrEF treated with sacubitril/valsartan showed a greater improvement in LVEF compared to men, though clinical outcomes were similar across sexes. Female sex was not a predictor of ventricular tachyarrhythmias or mortality at 12 months.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1503414"},"PeriodicalIF":2.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921115","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":"Construction and validation of a readmission risk prediction model for elderly patients with coronary heart disease.","authors":"Hanyu Luo, Benlong Wang, Rui Cao, Jun Feng","doi":"10.3389/fcvm.2024.1497916","DOIUrl":"10.3389/fcvm.2024.1497916","url":null,"abstract":"<p><strong>Background: </strong>To investigate the risk factors for readmission of elderly patients with coronary artery disease, and to construct and validate a predictive model for readmission risk of elderly patients with coronary artery disease within 3 years by applying machine learning method.</p><p><strong>Methods: </strong>We selected 575 elderly patients with CHD admitted to the Affiliated Lu'an Hospital of Anhui Medical University from January 2020 to January 2023. Based on whether patients were readmitted within 3 years, they were divided into two groups: those readmitted within 3 years (215 patients) and those not readmitted within 3 years (360 patients). Lasso regression and multivariate logistic regression were used to compare the predictive value of these models. XGBoost, LR, RF, KNN and DT algorithms were used to build prediction models for readmission risk. ROC curves and calibration plots were used to evaluate the prediction performance of the model. For external validation, 143 patients who were admitted between February and June 2023 from a different associated hospital in Lu'an City were also used.</p><p><strong>Results: </strong>The XGBoost model demonstrated the most accurate prediction performance out of the five machine learning techniques. Diabetes, Red blood cell distribution width (RDW), and Triglyceride glucose-body mass index (TyG-BMI), as determined by Lasso regression and multivariate logistic regression. Calibration plot analysis demonstrated that the XGBoost model maintained strong calibration performance across both training and testing datasets, with calibration curves closely aligning with the ideal curve. This alignment signifies a high level of concordance between predicted probabilities and observed event rates. Additionally, decision curve analysis highlighted that both decision trees and XGBoost models achieved higher net benefits within the majority of threshold ranges, emphasizing their significant potential in clinical decision-making processes. The XGBoost model's area under the ROC curve (AUC) reached 0.903, while the external validation dataset yielded an AUC of 0.891, further validating the model's predictive accuracy and its ability to generalize across different datasets.</p><p><strong>Conclusion: </strong>TyG-BMI, RDW, and diabetes mellitus at the time of admission are the factors affecting readmission of elderly patients with coronary artery disease, and the model constructed based on the XGBoost algorithm for readmission risk prediction has good predictive efficacy, which can provide guidance for identifying high-risk patients and timely intervention strategies.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1497916"},"PeriodicalIF":2.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11689274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913932","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":"Cardiac cells and mesenchymal stem cells derived extracellular vesicles: a potential therapeutic strategy for myocardial infarction.","authors":"Dan Qin, Xiaobo Wang, Jun Pu, Houxiang Hu","doi":"10.3389/fcvm.2024.1493290","DOIUrl":"10.3389/fcvm.2024.1493290","url":null,"abstract":"<p><p>Despite improvements in clinical outcomes of acute myocardial infarction (AMI), mortality rates remain high, indicating the need for further understanding of the pathogenesis and developing more effective cardiac protection strategies. Extracellular vesicles (EVs) carry proteins and noncoding RNAs (ncRNAs) derived from different cardiac cell populations, mainly including cardiomyocytes, endothelial cells, endothelial progenitor cells, cardiac progenitor cells, cardiosphere-derived cells, immune cells, fibroblasts and cardiac telocytes have vital roles under both physiological and pathological process such as myocardial infarction (MI). The content of EVs can also indicate the status of their parental cells and serve as a biomarker for monitoring the risk of cardiac injury. Examining these vesicles can offer fresh perspectives on the development of MI and assist in creating innovative treatments. Additionally, mesenchymal stem cells (MSCs) (MSC-EVs) derived EVs have been shown to have significant potential in cardiac regeneration. In this review, we will discuss the current understanding of the role of EVs in cardiac communication, with a focus on the perspectives of EVs from various cardiac cells and MSCs for their potential uses as cardiac therapies after MI.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1493290"},"PeriodicalIF":2.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913578","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":"Cardiovascular risk profile with SCORE2 and SCORE2-OP: comparing Portugal, Spain, Italy, and France using the new European predictive models.","authors":"Mariana Fontainhas, Cristina Gavina, Joana Miranda, Raquel Pereira-Silva, João Guichard, Daniela Seixas, Francisco Araújo","doi":"10.3389/fcvm.2024.1509240","DOIUrl":"10.3389/fcvm.2024.1509240","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to characterize the cardiovascular risk profile in countries with low-to-moderate cardiovascular mortality risk (Italy, Portugal, France, and Spain) using the SCORE2 and SCORE2-OP models. It also examines regional variations and the involvement of healthcare professionals in performing risk assessments.</p><p><strong>Methods: </strong>A retrospective observational study was conducted using data from 24,434 cardiovascular risk assessments performed between December 2022 and July 2023 through a digital application used by physicians. The assessments used the SCORE2 model for individuals aged 40-69 and the SCORE2-OP model for those aged 70 and older. Risk stratification into \"low-to-moderate,\" \"high,\" and \"very high\" categories was analyzed based on individual risk factors such as age, smoking habits, systolic blood pressure, and cholesterol levels.</p><p><strong>Results: </strong>Approximately 50%-60% of individuals in these countries were classified as having \"high\" or \"very high\" cardiovascular risk. The highest proportions were observed in Portugal (62.44%) and Italy (64.05%), while lower proportions were found in Spain (46.65%) and France (52.74%). Regional analysis identified areas with the highest cardiovascular risk, such as Portalegre in Portugal and Apulia in Italy. Key risk factors included older age, smoking, high systolic blood pressure, and high non-HDL cholesterol. General practitioners were the primary healthcare professionals conducting these assessments.</p><p><strong>Discussion: </strong>The study highlights a significant proportion of individuals with \"high\" or \"very high\" cardiovascular risk in countries with low-to-moderate mortality risk. These findings underscore the need for targeted cardiovascular disease prevention strategies and the crucial role of general practitioners in managing cardiovascular risk.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1509240"},"PeriodicalIF":2.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913592","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 blood metals and cardiovascular diseases: findings from National Health and Nutrition Examination Survey 2011-2020.","authors":"Bin Li, Haiyue Liu, Devrakshita Mishra, Zhen Yuan, Yizhi Zhang, Longzhen Zhang, Yanshu Huang, Ye Zhang, Ju Lin, Jianyou Chen, Zuheng Liu","doi":"10.3389/fcvm.2024.1479665","DOIUrl":"10.3389/fcvm.2024.1479665","url":null,"abstract":"<p><strong>Objectives: </strong>Previous studies have examined the relationship between cardiovascular diseases (CVDs) and blood metal levels. However, fewer studies have investigated the role of the combinations of blood metals on CVDs. In the current study, our aim is to explore the roles of specific blood metals and further develop a model to differentiate between healthy participants and CVD patients using database from the National Health and Nutrition Examination Survey (NHANES).</p><p><strong>Methods: </strong>Data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2020 were collected and utilized in the present study. Demographic characteristics and examination results were gathered and analyzed to compare CVD and non-CVD participants. Logistic regression and random forest analyses were employed to determine the odds ratios and the effects of various blood metals on CVDs.</p><p><strong>Results: </strong>A total of 23,448 participants were included and analyzed. Participants were divided into CVD (<i>n</i> = 2,676, 11.41%) and Non-CVD (<i>N</i> = 20,772, 88.59%) groups. A significant difference in the increased odds ratio of CVDs and higher blood Lead levels was found in the logistic analysis [OR (95% CI) = 13.545 (8.470-21.662) <i>P</i> < 0.001]. Although this significance blunted in the adjusted model, blood lead levels could be identified as the most important score through the random forest model in distinguishing cardiovascular diseases. In addition, the odds ratio of CVDs in logistic regression was 1.029 (95% CI: 1.022-1.035) for participants with higher blood cadmium levels (<i>p</i> < 0.001). The odds ratio increased [OR (95% CI) = 1.041 (95% CI: 1.032-1.049) <i>P</i> < 0.001] after the necessary adjustments were made for the gender, age, BMI, race and education background. In addition, blood selenium seems to be a protective factor of CVDs as the odds ratios were 0.650 and 0.786 in the crude and adjusted models, respectively. Additionally, the AUC was 0.91 in the predivtive model made by using the data of clinical indices and blood metals.</p><p><strong>Conclusions: </strong>In summary, blood metals may play an important role in the onset and progression of CVDs, and they can be used to develop a predictive model for CVDs, which might be beneficial for the identification and early diagnosis of CVDs.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1479665"},"PeriodicalIF":2.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913920","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":"Cardiac deceleration capacity and acceleration capacity have diagnostic value in patients with vasovagal syncope regardless of age.","authors":"Jijing Wang, Jinyi Xu, Yanyan Qiu, Ruike Yang, Wentao Wang, Chuanyu Gao","doi":"10.3389/fcvm.2024.1495129","DOIUrl":"10.3389/fcvm.2024.1495129","url":null,"abstract":"<p><strong>Background: </strong>Deceleration capacity (DC) and acceleration capacity (AC) are used to characterize autonomic regulation. The purpose of this study was to evaluate the autonomic nervous function in patients with vasovagal syncope (VVS) and to evaluate the diagnostic value of DC and AC for VVS.</p><p><strong>Methods: </strong>A total of 94 consecutive patients with VVS [51.0 (38.0-60.0) years; 48 males] and 76 healthy subjects [53.0 (44.3-62.8) years; 46 males] were recruited as controls. The study compared DC, AC, and heart rate variability (HRV) in 24-h ECG, echocardiogram, and biochemical examinations between the two groups.</p><p><strong>Results: </strong>DC was significantly higher (9.3 ± 2.1 vs. 7.4 ± 1.4 ms, <i>p</i> < .001) and AC was lower (-9.3 ± 2.1 vs. -7.3 ± 1.3 ms, <i>p</i> < .001) in the syncope group compared to the control group. HRV indicators were higher in the syncope group. In multivariable analyses, DC [odds ratio = 1.746 (95% CI, 1.389-2.195); <i>p</i> < .001], AC [odds ratio = 0.553 (95% CI, 0.435-0.702); <i>p</i> < .001] were independently associated with syncope. Mean HR was associated with syncope only in patients <60 years of age. Receiver operating characteristics (ROC) curves showed areas under curve (AUC) of DC/AC for predicting syncope are 0.755/0.765 with sensitivity of 56.4%/60.6% and specificity of 93.4%/88.2%.</p><p><strong>Conclusion: </strong>Patients with VVS exhibit higher DC and lower AC. Both DC and AC are independently correlated with syncope. A DC value >9.0 ms and an AC value -9.0 ms could potentially be valuable indicators for monitoring cardiac autonomic nervous dysfunction.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1495129"},"PeriodicalIF":2.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913659","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}