Frontiers in Cardiovascular Medicine最新文献

{"title":"Correlation between pulmonary to systemic flow ratio and N-terminal Pro-B-type natriuretic peptide level in children with atrial septal defect.","authors":"Li-Chin Liao, Yun-Yu Chen, Yun-Ching Fu, Hui-Chih Hung","doi":"10.3389/fcvm.2025.1522603","DOIUrl":"10.3389/fcvm.2025.1522603","url":null,"abstract":"<p><strong>Introduction: </strong>Atrial septal defect (ASD) increases pulmonary to systemic flow ratio (<i>Q</i> _p/<i>Q</i> _s) which is an important determinant factor for treatment. N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels are correlated with volume overloading of the heart. This study aims to explore the relationship between <i>Q</i> _p/<i>Q</i> _s and NT-proBNP levels in children with ASD.</p><p><strong>Materials and methods: </strong>Between January 2010 and December 2023, 464 patients under 20 years old with ASD who underwent cardiac catheterization and received NT-proBNP test were enrolled retrospectively. Baseline characteristics such as sex, body weight, and age were recorded. <i>Q</i> _p/<i>Q</i> _s was measured during standardized right heart catheterization according to Fick principle.</p><p><strong>Results: </strong>A significant positive correlation existed between NT-proBNP and <i>Q</i> _p/<i>Q</i> _s (R = 0.507, <i>P</i> < 0.001), with an <i>R</i> ² of 0.258. The linear regression model indicates that a one-unit (pg/ml) increase in NT-proBNP corresponded to a 0.003-unit increase in <i>Q</i> _p/<i>Q</i> _s (<i>P</i> < 0.001). Patients with a <i>Q</i> _p/<i>Q</i> _s ratio ≥ 2 had significantly higher NT-proBNP levels than those with a ratio <2 (<i>P</i> < 0.001).</p><p><strong>Conclustion: </strong>This study, the largest cohort to date, reveals the correlation between non-invasive NT-proBNP level and invasive <i>Q</i> _p/<i>Q</i> _s measurement in children with ASD.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1522603"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751678","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":"Cross-Sectional analysis of demographic and clinical characteristics of patients in the United States using icosapent ethyl.","authors":"Peter P Toth, John R Nelson, Handrean Soran, Om P Ganda, Nathan D Wong, Hakima Hannachi, David Abrahamson, Josh Hartman, Sierra Luciano, Sephy Philip","doi":"10.3389/fcvm.2025.1411233","DOIUrl":"10.3389/fcvm.2025.1411233","url":null,"abstract":"<p><strong>Introduction: </strong>Icosapent ethyl (IPE) is indicated for the treatment of severe hypertriglyceridemia (triglycerides ≥500 mg/dl) and for reducing the risk of cardiovascular (CV) events in statin-treated adults with moderately elevated triglycerides (150-499 mg/dl) and established CV disease [secondary prevention (SP)] or diabetes with CV risk factors [primary prevention (PP)]. We describe real-world characteristics of US patients taking IPE.</p><p><strong>Methods: </strong>Patients with ≥2 IPE prescriptions were identified in the TriNetX database. PP criteria were: ≥50 years with diabetes mellitus, ≥1 additional CV risk factor, and triglycerides 150-499 mg/dl. SP criteria were established CV disease and triglycerides 150-499 mg/dl.</p><p><strong>Results: </strong>Among patients with ≥2 IPE prescriptions and triglyceride data, 56.2% (18,897/33,645) met PP or SP criteria, 28.0% (9,431/33,645) had severe hypertriglyceridemia. In the PP and SP cohorts, mean (SD) ages were 62.7 (8.0) and 64.0 (10.7) years, respectively. In the SP cohort, coronary artery disease was the most common pre-existing CV disease (85.8%) and many had diabetes (63.1%). In the PP and SP cohorts, 81.7% and 90.4%, respectively, received statin treatment. Before IPE initiation, mean (SD; median) triglyceride levels were 305 (150; 253) and 279 (142; 230) mg/dl in the PP and SP cohorts, respectively, and mean/median LDL-C levels were <100 mg/dl in both.</p><p><strong>Discussion: </strong>Patients taking IPE had characteristics consistent with its indication, including well-controlled LDL-C levels with statin use. The higher triglyceride levels before IPE initiation suggest that IPE may be underutilized in patients at high risk for CV events; however, future studies are needed.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1411233"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751683","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":"Short-term recurrent coronary artery thrombosis with acute myocardial infarction in a patient with aplastic anemia-paroxysmal nocturnal hemoglobinuria syndrome: a case report.","authors":"Xue-Guo Fu, Yan-Hua Guo, Shi-Chao Wang, Wen-Quan Zhang","doi":"10.3389/fcvm.2025.1532842","DOIUrl":"10.3389/fcvm.2025.1532842","url":null,"abstract":"<p><strong>Background: </strong>Acute myocardial infarction commonly occurs in patients with coronary artery disease, but rarely, it can develop under a hypercoagulable state. Aplastic anemia can be accompanied by paroxysmal nocturnal hemoglobinuria clones or transform into paroxysmal nocturnal hemoglobinuria with a significantly elevated prothrombotic state. These thrombotic complications predominantly arise in veins rather than in arteries. Coronary artery thrombosis in these patients, especially with short-term recurrent arterial thrombosis after initial successful treatment, is exceedingly rare.</p><p><strong>Case presentation: </strong>A 39-year-old man with a history of aplastic anemia with paroxysmal nocturnal hemoglobinuria clones for 8 years presented with chest pain, and was diagnosed with acute inferior wall myocardial infarction on November 21, 2022. Despite standardized coronary intervention and anticoagulant/antiplatelet therapy, the patient reported intermittent chest discomfort with persistently elevated cardiac troponin and d-dimer levels 20 days after initial treatment. Repeat coronary angiography confirmed recurrent thrombosis in the right coronary artery. He underwent repeated balloon dilation and thrombus aspiration with intensified anticoagulation, which alleviated his clinical symptoms and normalized his cardiac troponin and d-dimer levels. The patient was finally confirmed to have aplastic anemia-paroxysmal nocturnal hemoglobinuria syndrome.</p><p><strong>Conclusion: </strong>Patients with aplastic anemia-paroxysmal nocturnal hemoglobinuria syndrome can have thrombosis in arteries, such as coronary arteries, leading to acute myocardial infarction. Recurrent coronary artery thrombosis can occur after initial successful revascularization and anticoagulant/antiplatelet therapy. Close monitoring of clinical symptoms, repeated electrocardiogram and laboratory tests, coronary angiography, strengthened anticoagulation, and precautions for bleeding risks should be considered in patients with aplastic anemia-paroxysmal nocturnal hemoglobinuria syndrome.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1532842"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751868","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":"Detection of arterial remodeling using epicardial adipose tissue assessment from CT calcium scoring scan.","authors":"Juhwan Lee, Tao Hu, Michelle C Williams, Ammar Hoori, Hao Wu, Justin N Kim, David E Newby, Robert Gilkeson, Sanjay Rajagopalan, David L Wilson","doi":"10.3389/fcvm.2025.1543816","DOIUrl":"10.3389/fcvm.2025.1543816","url":null,"abstract":"<p><strong>Introduction: </strong>Non-contrast CT calcium scoring (CTCS) exams have been widely used to assess coronary artery disease. However, their clinical applications in predicting coronary arterial remodeling remain unknown. This study aimed to develop a novel machine learning model to predict positive remodeling (PR) from CTCS scans and evaluate its clinical value in predicting major adverse cardiovascular events (MACE).</p><p><strong>Methods: </strong>We analyzed data from 1,324 patients who underwent both CTCS and CT angiography. PR was defined as an outer vessel diameter at least 10% greater than the average diameter of the segments immediately proximal and distal to the plaque. We utilized a total of 246 features, including 23 clinical features, 12 Agatston score-derived features, and 211 epicardial fat-omics features to predict PR. Feature selection was performed using Elastic Net logistic regression, and the selected features were used to train a CatBoost machine learning model. Classification performance was evaluated using 1,000 repetitions of five-fold cross-validation and survival analyses, comparing actual and predicted PR in the context of predicting MACE.</p><p><strong>Results: </strong>PR was identified in 429 patients (32.4%). Using Elastic Net, we identified the top 13 features, including four clinical features, three Agatston score-derived features, and six fat-omics features. Our method demonstrated excellent classification performance for predicting PR, achieving a sensitivity of 80.3 ± 1.7%, a specificity of 89.7 ± 1.7%, and accuracy of 81.9 ± 2.5%. The Agatston-score-derived and fat-omics features provided additional benefits, improving classification performance. Furthermore, our model effectively predicted MACE, with a hazard ratio (HR) of 4.5 [95% confidence interval (CI): 3.2-6.4; C-index: 0.578; <i>p</i> < 0.00001] in the training set and an HR of 3.2 (95% CI: 2.5-4.0; C-index: 0.647; <i>p</i> < 0.00001) in the external validation set.</p><p><strong>Conclusion: </strong>We developed an innovative machine learning model to predict coronary arterial remodeling from epicardial fat and calcification features from low-cost/no-cost screening CTCS scans. Our results suggest that vast number of CTCS scans can support more informed clinical decision-making and potentially reduce the need for invasive and costly testing for low-risk patients.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1543816"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751690","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":"Pharmacists delivering hypertension care services: a systematic review and meta-analysis of randomized controlled trials.","authors":"Viktoria Gastens, Stefano Tancredi, Blanche Kiszio, Cinzia Del Giovane, Ross T Tsuyuki, Gilles Paradis, Arnaud Chiolero, Valérie Santschi","doi":"10.3389/fcvm.2025.1477729","DOIUrl":"10.3389/fcvm.2025.1477729","url":null,"abstract":"<p><strong>Background: </strong>Community-based models of care with the involvement of pharmacists and other nonphysician healthcare professionals can help improve blood pressure (BP) control. We aimed to synthesize the evidence of effectiveness of pharmacist interventions on BP among patients with hypertension.</p><p><strong>Methods: </strong>We performed systematic searches to identify randomized controlled trials (RCTs) assessing the effect of pharmacist interventions on BP among outpatients (latest search, March 2024). The effect on systolic and diastolic BP change or BP control were pooled using random effects model. Subgroup analysis for the types of pharmacist interventions and healthcare settings were performed. The risk of bias was assessed using the Cochrane Risk of Bias Tool 2. The protocol was registered in PROSPERO (CRD42021279751) and published in an open-access peer-reviewed journal.</p><p><strong>Results: </strong>Out of 2,330 study records identified in 7 electronic databases, a total of 95 RCTs, with 31,168 participants (control 16,157, intervention 15,011), were included. The intervention was led by the pharmacist in 75% of the studies and in collaboration with other healthcare providers in 25%. Pharmacist interventions included patient education in 88%, feedback to healthcare providers in 49%, and patient reminders in 24% of the studies. Systolic and diastolic BP were reduced after pharmacist intervention by -5.3 mmHg (95% CI: -6.3 to -4.4; <i>I</i> ² = 86%) and -2.3 mmHg (95% CI: -2.9 to -1.8; <i>I</i> ² = 75%), respectively. The reduction of systolic BP tended to be larger if the intervention was collaborative, conducted in outpatient clinics, based on healthcare provider education, or through healthcare provider feedback. Analyses restricted to relatively large or high-quality studies yielded similar estimates, with lower between-studies heterogeneity.</p><p><strong>Conclusion: </strong>Pharmacist care for patients with hypertension consistently improves BP across various settings and interventions. Pharmacist care is one key element of the solution to the global burden of hypertension and cardiovascular diseases.</p><p><strong>Prospero registration number: </strong>CRD42021279751.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1477729"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751866","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":"A novel method using body surface steel ball as a reference scale to measure the left atrial appendage for optimal selection of Watchman device.","authors":"He Jin, Mingjun Feng, Xianfeng Du, Binhao Wang, Yibo Yu, Guohua Fu, Caijie Shen, Huimin Chu","doi":"10.3389/fcvm.2025.1464567","DOIUrl":"10.3389/fcvm.2025.1464567","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Left atrial appendage closure (LAAC) is an alternative to oral anticoagulation for stroke prevention in non-valvular atrial fibrillation (AF). Selecting the appropriate size of Watchman device is very important intra-procedure. There are several methods have been reported to measure the left atrial appendage (LAA), but each of them has its limitations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We investigated the efficacy and safety of using the novel \"steel ball method\" compared to using the traditional \"sheath method\" and TEE during procedure of LAAC with Watchman device in AF patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients with atrial fibrillation who underwent LAAC with Watchman device at The First Affiliated Hospital of Ningbo University from January 2018 to December 2021 were retrospectively analyzed. A 10 mm-diameter steel ball was placed on patient's body surface at the pulmonary valve auscultation zone before procedure. The maximum LAA ostium diameter, maximum LAA depth, and 1st sheath marker band length were measured under x-ray fluoroscopy, using the delivery sheath, pigtail sheath, and steel ball as references, respectively, which we called the delivery sheath group, pigtail sheath group and steel ball group. The maximum LAA ostium diameter and maximum LAA depth were also measured by TEE. All Watchman devices were selected based on the measurement of LAA by \"steel ball method\". The position of Watchman device and presence of peri-device leakage (PDL) were assessed using transesophageal echocardiography (TEE) before and after the release.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Eventually a total of 169 patients [63.3% male, age 69 (44-87) years, 73.4% persistent or permanent AF, CHA2DS2-VASc score 4.31 ± 1.54, HAS-BLED score 2.74 ± 1.15, left atrial diameter 44.09 ± 7.55 mm] underwent Watchman device implantation successfully were enrolled. The mean maximum LAA ostium diameter measured in steel ball group (24.73 ± 3.39 mm) was significantly higher than that in delivery sheath group (20.04 ± 3.24 mm, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and pigtail sheath group (22.48 ± 3.74 mm, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), while was not significantly different from the results measured by TEE (24.39 ± 4.13 mm, &lt;i&gt;p&lt;/i&gt; = 0.176). The difference between 1st sheath marker band length measured in steel ball group and the true length (21 mm) was 0.29 ± 0.61 mm, which was significantly less than that in delivery sheath group (4.22 ± 1.42 mm) and pigtail sheath group (2.17 ± 1.90 mm) (both &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Finally, the success rate of Watchman device implantation is 98.8%, with no serious intra-procedure complication. 2 patients (1.2%) occurred pericardial tamponade after procedure. 98.8% and 97.0% of patients had either no or slight (≤3 mm) PDL with immediate and 45 days post-procedural TEE scans, respectively. Device-related thrombosis (DRT) was detected in 1 patient (0.6%) and 2 patients (1.2%) had ischemic stroke during follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/st","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1464567"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751484","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":"Effects of weight loss after sleeve gastrectomy on left ventricular myocardial work in obese patients.","authors":"Xiao Ding, Xijun Zhang, Jingge Zhao, Changhua Wei, Shuaiwei Luo, Jianjun Yuan, Haohui Zhu","doi":"10.3389/fcvm.2025.1525746","DOIUrl":"10.3389/fcvm.2025.1525746","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a global epidemic and a major risk factor for cardiovascular diseases. Laparoscopic sleeve gastrectomy (LSG) is an effective bariatric surgery, but its effect on cardiac functions remains unclear. This study aims to investigate the impact of weight loss after LSG on the left ventricular myocardial work (LVMW) in obese patients and explore the clinical value of the left ventricular pressure - strain loop (LV - PSL).</p><p><strong>Methods: </strong>Thirty - eight obese patients (body mass index ≥ 30 kg/m²) were enrolled preoperatively, and 31 patients completed the study after six months of follow - up. Clinical information, parameters from left ventricular myocardial work and traditional two - dimensional strain echocardiography were collected and analyzed.</p><p><strong>Results: </strong>After LSG, significant reductions in body mass index (BMI), diastolic blood pressure (DBP) and weight were observed. Cardiac output (CO), stroke volume (SV), left ventricular end - diastolic volume (LVEDV), left ventricular end - systolic volume (LVESV), left ventricular ejection fraction (LVEF), Peak E, e', and a' decreased, while left ventricular mass index increased. Myocardial work parameters also showed significant changes after LSG, with global longitudinal strain (GLS) and global work efficiency (GWE) increasing and global work index (GWI), global constructive work (GCW), and global wasted work (GWW) decreasing. Significant correlations were observed between the differences in GWW and left ventricular end - diastolic diameter (LVDd), as well as between the differences in GWI and LVEDV. The differences in left ventricular mass and its index were both significantly negatively correlated with the difference in GWW.</p><p><strong>Conclusions: </strong>LV - PSL can effectively evaluate left ventricular myocardial work in obese patients. Weight loss after LSG can improve left ventricular myocardial work efficiency, and the associated parameter changes are related to cardiac structure, offering new clinical references.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1525746"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751726","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":"Integrated meta-analysis and network pharmacology analysis: evaluation of Zhigancao decoction as treatment for diabetic cardiomyopathy.","authors":"Kangshou Ji, Meizi Han, Mingqian Yang, Qian Xu, Yan Zhang","doi":"10.3389/fcvm.2025.1454647","DOIUrl":"10.3389/fcvm.2025.1454647","url":null,"abstract":"<p><strong>Background: </strong>Zhigancao Decoction (ZGCD) is derived from \"Treatise on Febrile Diseases\" and is traditionally prescribed for treating a variety of cardiovascular conditions. As of now, there are no data to support its use as a treatment for diabetic cardiomyopathy (DCM) and the mechanism behind the effect is unclear as well. In the present study, clinical evidence for the efficacy of ZGCD in patients with DCM was examined using a meta-analysis and its underlying anti-DCM molecular mechanisms were explored via network pharmacology.</p><p><strong>Methods: </strong>The current study utilized an extensive search strategy encompassing various domestic and foreign databases databases to retrieve pertinent articles published up to June 2024. In light of this, a thorough evaluation of the benefits and safety of Zhigancao decoction (ZGCD) was conducted in this study using RevMan and Stata. Subsequently, a number of active compounds and target genes for ZGCD were gathered from the TCMSP and BATMAN-TCM databases, while the main targets for DCM were obtained from databases such as GenCards, OMIM, TTD, and DrugBank. To select core genes, protein-protein interaction networks were generated using the STRING platform, and enrichment analyses were completed using the Metascape platform.</p><p><strong>Results: </strong>Meta-analysis results were ultimately derived from 9 studies involving 661 patients in total. In comparison with WM therapy alone, the pooled results showed that ZGCD significantly enhanced overall effectiveness. Additionally, the utilization of ZGCD was leading to a reduction in LVEDV, LVESV and LVDD, also a greater increase in LVEF. Meanwhile, the utilization of ZGCD during intervention was more effective in reducing SBP, and DBP. In addition, the ZGCD showed potential in reducing the occurrence of adverse events. In the context of network pharmacology, five constituents of ZGCD-namely lysine, quercetin, gamma-aminobutyric acid, stigmasterol, and beta-sitosterol-are posited to exert anti-diabetic cardiomyopathy (anti-DCM) effects through interactions with the molecular targets ASS1, SERPINE1, CACNA2D1, AVP, APOB, ICAM1, EGFR, TNNC1, F2, F10, IGF1, TNNI2, CAV1, INSR, and INS. The primary mechanisms by which ZGCD may achieve its anti-DCM effects are likely mediated via the AGEs/RAGE signaling pathway, as well as through pathways related to lipid metabolism and atherosclerosis.</p><p><strong>Conclusion: </strong>In comparison to WM therapy alone, ZGCD demonstrates greater efficacy and safety in the management of DCM. ZGCD not only significantly reduces blood pressure, but also enhances cardiac function while producing fewer adverse effects. The therapeutic effects of ZGCD on DCM can likely be ascribed to its capacity to modulate the AGEs-RAGE signaling pathway, as well as its efficacy in enhancing lipid metabolism and mitigating atherosclerosis.</p><p><strong>Systematic review registration: </strong>identifier (INPLASY202430133).</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1454647"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751835","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":"Estimated plasma volume status as a prognostic indicator in myocardial infarction and heart failure: insights from the MIMIC-IV database.","authors":"Bin Luo, Zheng Ma, Guoyong Zhang, Xue Jiang, Caixia Guo","doi":"10.3389/fcvm.2025.1499378","DOIUrl":"10.3389/fcvm.2025.1499378","url":null,"abstract":"<p><strong>Background: </strong>Myocardial infarction (MI) complicated by heart failure (HF) is a common and severe clinical condition associated with poor outcomes. Estimated plasma volume status (ePVS), a marker of congestion derived from hemoglobin and hematocrit, has shown promise in predicting outcomes in various cardiovascular diseases. This study aimed to investigate the relationship between ePVS and both short-term and long-term prognosis in patients with MI complicated by HF.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, including 3,238 patients with MI complicated by HF. Patients were stratified into quartiles based on ePVS values. The primary outcomes were in-hospital mortality, 180-day mortality, and 1-year mortality. Kaplan-Meier curves, multivariate Cox regression analysis, and subgroup analyses were performed to assess the relationship between ePVS and outcomes.</p><p><strong>Results: </strong>Kaplan-Meier analysis showed significant differences in survival rates across ePVS quartiles for all outcomes (<i>P</i> < 0.001). Multivariate logistic regression analysis revealed that patients in the highest quartile of ePVS (Q4 vs. Q1) had an independently increased risk of in-hospital mortality (OR 1.58, 95% CI 1.16-2.13, <i>P</i> = 0.003). Cox regression analysis further demonstrated that higher ePVS (Q4 vs. Q1) was associated with an increased risk of 180-day mortality (HR 1.45, 95% CI 1.19-1.75, <i>P</i> < 0.001) and 1-year mortality (HR 1.51, 95% CI 1.27-1.80, <i>P</i> < 0.001). Both Kaplan-Meier survival curves and restricted cubic spline models confirmed a positive association between ePVS and long-term mortality risks.The association between ePVS and long-term outcomes was stronger than for in-hospital mortality. Subgroup analyses revealed that the relationship between ePVS and long-term mortality was more pronounced in patients with systolic blood pressure below 140 mmHg, lower LODS and OASIS scores, and those without hemorrhagic disorders or anemia (<i>P</i> for interaction <0.05).</p><p><strong>Conclusion: </strong>ePVS was an independent predictor of both short-term and long-term mortality in patients with MI complicated by HF. Its prognostic value was particularly significant for long-term outcomes, suggesting its potential utility in risk stratification and guiding treatment strategies for this high-risk population.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1499378"},"PeriodicalIF":2.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729666","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":"Adherence to proper blood pressure measurements among interns at the university of Gondar specialized referral hospital.","authors":"Mihret Getnet, Amare Belete Getahun, Desalegn Anmut Bitew, Ayechew Adera Getu","doi":"10.3389/fcvm.2025.1436256","DOIUrl":"10.3389/fcvm.2025.1436256","url":null,"abstract":"<p><strong>Introduction: </strong>Blood pressure is a lateral force exerted on the wall of arteries and is critical for the normal distribution of blood containing nutrients and oxygen to metabolic tissues. It is one of the vital signs often measured by interns, nurses, and physicians at doctor's offices, at bedside, and possibly at home. Accurate blood pressure measurement is essential for proper diagnosis and management of patients, especially those with hypertension. The aim of this cross-sectional survey study is to assess the practice of measuring blood pressure by interns.</p><p><strong>Methods: </strong>This study was conducted in the form of a survey administered through face-to-face interviews. All the interns at the Univeristy of Gondar Specialized Referral Hospital were approached. The survey included questions about devices used, patient's information, and blood pressure measurement techniques. Epi-Data version 3.1 was used for data entry and exported to STATA 17 for data management and analysis. The Chi-square test was checked to assess the eligibility of variables for logistic regression. Finally, in the multivariable binary logistic regression analysis, variables with <i>P</i>-value < 0.05 were considered to be statistically significantly associated. The Adjusted Odds Ratio (AOR) with 95% CI was reported to declare the statistical significance and strength of association between blood pressure measurement and independent variables.</p><p><strong>Result: </strong>The magnitude of appropriate measurement of blood pressure among interns was 10.1 (95% CI: 7.19, 13.9). A total of 318 interns participated in the current study. Of these study participants, 65.4% (208) were males. A increase in participants age (AOR: 1.48, 95% CI: 1.09, 2.01), being male interns (AOR: 5.51, 95% CI: 1.51, 8.97), and having patients who were familiar with the procedure (AOR: 2.95, 95% CI: 1.19, 7.03) were factors significantly associated with appropriate adherence to blood pressure measurement.</p><p><strong>Conclusion and recommendation: </strong>Only 10% of six-year medical students (Interns) were successful in appropriately assessing blood pressure. Age, being male, and patient understanding were factors significantly associated to the adherence of blood pressure measurement. Considering the frequency of BP measurement and the impact of hypertension on morbidity and mortality, efforts are needed to maximize the quality of BP measurement by health professionals. This process should begin early during training and be consistent throughout their clinical practice, supplemented by ongoing education.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1436256"},"PeriodicalIF":2.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718513","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}