Frontiers in Cardiovascular Medicine最新文献

{"title":"The correlation between lipoprotein(a) and major adverse cardiovascular events in patients with acute myocardial infarction combined with heart failure with preserved ejection fraction.","authors":"Xiaodong Zhang, Nan Niu, Shengqin Yu, Xinxin Zhang, Yanli Zhang, Xuefu Chen, Wenmiao Zhang, Song Yang, Ning Zhang, Yunlong Xia, Ying Liu","doi":"10.3389/fcvm.2025.1515916","DOIUrl":"10.3389/fcvm.2025.1515916","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to confirm the correlation between lipoprotein(a) [Lp(a)] and major adverse cardiovascular events (MACE) in patients with acute myocardial infarction (AMI) combined with heart failure with preserved ejection fraction (HFpEF).</p><p><strong>Methods: </strong>This retrospective study was conducted at the First Affiliated Hospital of Dalian Medical University and included 399 patients who were diagnosed with AMI combined with HFpEF and who were hospitalised and underwent percutaneous coronary intervention (PCI) treatment between January 1, 2018, and January 1, 2023. Based on Lp(a) levels, patients were divided into three tertiles: T1 (≤356 mg/L), T2 [356 mg/L < Lp(a) ≤ 487 mg/L], and T3 (>487 mg/L). The study employed univariate and multivariate Cox regression analysis, subgroup analysis, and receiver operating characteristic (ROC) curve analysis to evaluate the correlation between Lp(a) and MACE.</p><p><strong>Results: </strong>Compared to the non-MACE group, the MACE group had higher levels of Lp(a) (<i>P</i> < 0.001). Tertile-based analysis of Lp(a) levels showed that as Lp(a) increased, the incidence of MACE, rehospitalization due to worsening HF, non-fatal recurrent MI, and unplanned repeat revascularization all increased significantly (all <i>P</i> < 0.05). During an average follow-up period of 30.5 months, multivariate Cox regression analysis confirmed that Lp(a) consistently remained an independent predictor of MACE across unadjusted, partially adjusted, and fully adjusted models (all <i>P</i> < 0.05). Further component analysis indicated that Lp(a) was significantly associated with cardiac death, rehospitalization due to worsening HF, and non-fatal recurrent MI, with the highest risk observed in the T3 group. Subgroup analysis further demonstrated that the association between elevated Lp(a) and MACE remained statistically significant across various strata (all <i>P</i> < 0.05). ROC curve analysis revealed that the area under the curve (AUC) for Lp(a) in predicting MACE was 0.662 (95% CI: 0.607-0.718), which was higher than that of systolic blood pressure (AUC = 0.560) and fasting plasma glucose (AUC = 0.543), but not significantly different from age (AUC = 0.610, <i>P</i> = 0.211).</p><p><strong>Conclusions: </strong>In patients with AMI combined with HFpEF, elevated Lp(a) levels were significantly associated with an increased risk of MACE, and this association remained consistent across multiple subgroups.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1515916"},"PeriodicalIF":2.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474496","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":"Familial hypercholesterolaemia with early-onset coronary artery disease and recurrent in-stent restenosis associated with the LDLR gene c.428G>A mutation: a case report.","authors":"Chengpeng Zhang, Hui Li, Wei Zhang, Jian Huang, Jing Zhu","doi":"10.3389/fcvm.2025.1573543","DOIUrl":"10.3389/fcvm.2025.1573543","url":null,"abstract":"<p><strong>Background: </strong>Familial hypercholesterolaemia (FH) is characterised by significantly elevated low-density lipoprotein cholesterol (LDL-C) levels and early-onset coronary artery disease. Additionally, clopidogrel resistance is observed in approximately 30%-50% of individuals globally. Among FH patients with early-onset coronary artery disease, inadequate LDL-C management and suboptimal antiplatelet therapy after stent implantation are key factors contributing to recurrent in-stent restenosis (ISR).</p><p><strong>Case presentation: </strong>A 65-year-old male with a history of coronary artery disease (CAD), hyperlipidemia, and prior angioplasty presented to our institution with exacerbation of angina symptoms. The patient's CAD was initially diagnosed at age 52 (early-onset), with subsequent coronary angiography performed at Lianshui County Hospital. Coronary angiography confirmed coronary artery disease, prompting percutaneous coronary intervention (PCI) with stent placement: one in the right coronary artery and another in the left circumflex artery. Despite receiving standard antiplatelet (aspirin enteric-coated tablets 100 mg, clopidogrel 75 mg) and lipid-lowering therapy (pitavastatin calcium 2 mg), his LDL-C levels remained poorly controlled, and chest pain recurred. At the age of 62 and 65, he developed ISR with additional coronary artery lesions, necessitating balloon angioplasty. FH gene sequencing and clopidogrel resistance testing found he have a heterozygous LDL receptor (LDLR) gene mutation (c.428G>A, p.Cys143Tyr) and a clopidogrel genotype of CYP2C19 *1/*2. Based on these findings, his antiplatelet and lipid-lowering therapies were adjusted (aspirin 100 mg, clopidogrel 150 mg, rosuvastatin 10 mg, ezetimibe 10 mg and alirocumab 150 mg biweekly). Follow-up revealed that his LDL-C levels reached target values, and he remained asymptomatic. One year later, coronary angiography showed no disease progression, and the patient experienced no recurrence of chest pain. This case highlights the efficacy of precision treatment.</p><p><strong>Conclusions: </strong>For FH patients with early-onset CAD who are intolerant to ticagrelor, early implementation of FH genetic sequencing and clopidogrel genotyping is critical for personalised treatment.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1573543"},"PeriodicalIF":2.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474485","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":"Lipid accumulation product index is inversely U-shaped associated with abdominal aortic calcification based on NHANES 2013-2014.","authors":"Jiangbei Deng, Xiao Qin","doi":"10.3389/fcvm.2025.1524847","DOIUrl":"10.3389/fcvm.2025.1524847","url":null,"abstract":"<p><strong>Background: </strong>In this study, we explored the correlation between lipid accumulation product (LAP) and abdominal aortic calcification (AAC).</p><p><strong>Methods: </strong>Data collected from 2013-2014 were obtained from the National Health and Nutrition Examination Survey (<i>N</i>HANES) database. We utilized weighted univariate and multivariate regression analyses to assess the correlation between ln-LAP (LAP was transformed using a natural logarithm) and AAC. Further, subgroup analyses, smoothed curve fitting, and sensitivity analysis were implemented.</p><p><strong>Results: </strong>The study included 2,965 participants, with a mean ln-LAP index of 3.95 ± 0.83. Following adjustment for all covariates, multiple regression analyses indicated that ln-LAP, when modeled as a quadratic categorical variable, was significantly positively associated with AAC in Q3 (OR = 1.91; 95% CI: 1.20, 3.04, <i>P</i> < 0.001) compared to the Q1, and similarly, with severe abdominal aortic calcification (SAAC) in Q4 (OR = 2.17; 95% CI: 1.08, 4.35, <i>P</i> < 0.05). Conversely, Q2, Q3, and Q4 did not exhibit significant positive correlations with AAC scores (<i>P</i> > 0.05). Smoothed curve fitting revealed a nonlinear relationship between ln-LAP and AAC, characterized by an inverse U-shaped curve. Threshold effect analysis identified an inflection point at 4.21. Before this point, a marked positive correlation existed between ln-LAP and AAC (OR=1.74); beyond this point, a pronounced negative correlation was observed (OR=0.60). Subgroup analyses revealed no significant interactions regarding the correlation across age, sex, hypertension, and diabetes groups (<i>P</i> interaction >0.05).</p><p><strong>Conclusions: </strong>This research reveals a significant inverse U-shaped correlation between LAP and the prevalence of AAC, implying that LAP could serve as a potential biomarker for evaluating AAC risk.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1524847"},"PeriodicalIF":2.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474487","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":"Analysis of risk factors and the predictive value of a nomogram model for coronary heart disease in patients with rheumatoid arthritis.","authors":"Guozhu Che, Xing Zhao, Haizhuan An, Yanyan Wang, Qianyu Guo, Ke Xu","doi":"10.3389/fcvm.2025.1558012","DOIUrl":"10.3389/fcvm.2025.1558012","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is associated with an elevated risk of coronary heart disease (CHD) due to a complex interplay of traditional cardiovascular risk factors and RA-specific mechanisms. This study aimed to identify key risk factors for CHD in RA patients and develop a nomogram model for individualized risk prediction.</p><p><strong>Methods: </strong>A retrospective study was conducted involving 258 RA patients, including 32 with CHD and 226 without CHD, admitted between January 2021 and August 2024. Demographic, clinical, and laboratory data were collected. Multivariate logistic regression analysis identified independent risk factors, which were incorporated into a nomogram model. The model's performance was evaluated using the receiver operating characteristic (ROC) curve, calibration plots, and decision curve analysis (DCA). Internal validation was performed using bootstrap resampling.</p><p><strong>Results: </strong>Key risk factors for CHD in RA patients included hypertension, HbA1c, RA duration, carotid plaque burden, uric acid, and ECG abnormalities. The nomogram demonstrated excellent discriminative ability, with an area under the ROC curve (AUC) of 0.868 (95% CI: 0.819-0.916) and robust calibration (<i>P</i> = 0.908). Internal validation confirmed its reliability (AUC = 0.866). DCA indicated that the nomogram provided superior clinical utility by optimizing the net benefit across a range of threshold probabilities.</p><p><strong>Conclusions: </strong>This study identified hypertension, elevated HbA1c, prolonged RA duration, carotid plaque burden, increased uric acid levels, and ECG abnormalities as significant risk factors for CHD in RA patients. A nomogram prediction model incorporating these factors was developed, exhibiting outstanding discriminatory and calibration capabilities.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1558012"},"PeriodicalIF":2.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474467","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":"Efficacy of different polypill combinations for primary and secondary cardiovascular disease prevention: a systematic review and meta-analysis.","authors":"Habib Yazgi, Shivani Mattikalli, Brian Fang, Hannah Heselton, Paddy Ssentongo, Michael Farbaniec","doi":"10.3389/fcvm.2025.1558579","DOIUrl":"10.3389/fcvm.2025.1558579","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease is the leading cause of mortality and morbidity worldwide, and polypills have established efficacy in preventing poor outcomes. However, evidence on the optimal polypill combination is lacking. The objective of the study is to estimate the optimal polypill combination that maximizes cardiovascular outcomes.</p><p><strong>Methods: </strong>MEDLINE/PubMed, Scopus, and Cochrane Database of Systematic Reviews databases were searched from January 1, 1960, to March 30, 2025. Studies that provided data on the association between polypill and cardiovascular outcomes were included. We estimated the effect of various polypill combinations by random-effects meta-analyses using the generic inverse variance method. Subgroup and meta-regression analyses were conducted to explore potential effect modification in the association between polypill combinations and cardiovascular outcomes.</p><p><strong>Results: </strong>Thirty studies comprising 35,833 individuals met the inclusion criteria from 6 continents. The estimated pooled effects of polypill use on major adverse cardiovascular events (MACE), cardiovascular death, and all-cause mortality were RR 0.78 (95% CI, 0.63-0.97), 0.75 (95% CI, 0.63-0.89), 0.88 (95% CI, 0.79-0.98), respectively. The pooled relative risk of MACE outcome was 21% lower in combination of 4 or more pills [0.79 (95% CI, 0.55-1.15), <i>n</i> = 6 studies] vs. to 22% and 3 or less combination of medication classes (RR: 0.78 95% CI: 0.70-0.86), <i>n</i> = 4 studies). Polypill combinations containing moderate or high-intensity statins were associated with lower risk of MACE outcomes RR 0.79 95% CI: 0.70-0.97), <i>n</i> = 2 studies compared to combinations with low-intensity statins RR 0.78 95% CI: 0.59-1.03, <i>n</i> = 8). All polypills for MACE outcomes contained RAAS inhibitors. Calcium channel blockers, RAAS inhibitors and diuretics-containing polypills were associated with the highest reduction in blood pressure. Certainty of evidence for MACE ranged from low to high, with most trials rated as moderate to high.</p><p><strong>Conclusions: </strong>In this meta-analysis, polypills with 3 cardiovascular classes that contain a high-intensity statins, aspirin and RAAS inhibitors appeared to have greater reduction in MACE outcomes. The presence of a diuretic and a calcium channel blocker in the polypill was associated with greater reductions in systolic and diastolic blood pressure.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1558579"},"PeriodicalIF":2.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474484","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":"Association of plasma homocysteine with cardiovascular disease in American adults: a study based on the national health and nutrition examination survey database.","authors":"Zhaoming Huang, Qiaohui Zhang, Jie Zhang, Renyan Zhang, Yujie Huang, Demin Xu","doi":"10.3389/fcvm.2025.1528540","DOIUrl":"10.3389/fcvm.2025.1528540","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to investigate the correlation between plasma homocysteine (Hcy) levels and cardiovascular disease (CVD) in United States adults based on the National Health and Examination Survey (NHANES) database of the United States.</p><p><strong>Methods: </strong>Data from two survey periods (2003-2006) in the NHANES database were used as the research data set. Plasma Hcy levels are considered an independent variable, while CVD is a dependent variable. Weighted logistic regression, linear trend analysis, subgroup analysis and limiting cubic spline plots were used for analysis. A total of 4,418 samples were included.</p><p><strong>Results: </strong>In the weighted logistic regression model, a significant positive correlation between Hcy level and CVD risk was observed (<i>P</i> for trend = 0.007).The subgroup analysis revealed that various characteristics such as age, race, education level, obesity, alcohol use, diabetes, and hypertension did not affect this positive correlation (<i>P</i> for interaction ≥0.05). The nonlinear association between Hcy level and CVD risk was explored by limiting cubic spline plots, revealing the overall significant trend (<i>P</i> for overall <0.0001) and the significant nonlinear trend (<i>P</i> for nonlinear <0.01).</p><p><strong>Conclusion: </strong>In this large cross-sectional study, an increase in Hcy levels leads to an increased risk of CVD. There is a nonlinearly positive correlation between Hcy levels and the risk of CVD.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1528540"},"PeriodicalIF":2.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474468","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":"Association of the blood urea nitrogen to serum albumin ratio and 28-day all-cause mortality in patients with cardiac arrest: a retrospective cohort study using the MIMIC-IV database.","authors":"Gaosheng Zhou, Yayuan Tan, Xueli Li, Yixun Wang, Dingdeng Wang, Min Liu","doi":"10.3389/fcvm.2025.1609059","DOIUrl":"10.3389/fcvm.2025.1609059","url":null,"abstract":"<p><strong>Background: </strong>The blood urea nitrogen to serum albumin ratio (BAR) has been identified as a novel indicator of both inflammatory and nutritional status, exhibiting a correlation with adverse cardiovascular outcomes.</p><p><strong>Objective: </strong>To explore the association between the BAR and 28-day all-cause mortality in cardiac arrest patients who achieved return of spontaneous circulation (ROSC) and were admitted to the intensive care unit (ICU).</p><p><strong>Methods: </strong>Data for patients with cardiac arrest were obtained from the Medical Information Mart for Intensive Care IV database. The outcome was 28-day all-cause mortality. Multivariable-adjusted Cox regression analysis, curve fitting, and threshold effects analysis were used to assess the relationship between the BAR and 28-day all-cause mortality in patients with cardiac arrest in the intensive care unit.</p><p><strong>Result: </strong>A total of 793 patients were included and divided into tertiles based on the BAR (Q1, Q2, Q3); 8-day all-cause mortality rates were 37.5%, 53.4%, and 63.8%, respectively (<i>P</i> < 0.001). A higher BAR at initial admission was significantly associated with an increased 28-day all-cause mortality risk. Results from the adjusted Models 2, 3, 4, and 5 were consistent with those of Model 1. Subgroup analysis revealed no interactions in age, sex, renal disease, liver disease, vasoactive drug use, ventilation, race, aids, malignant cancer, diabetes, peptic ulcer disease, rheumatic disease, chronic pulmonary disease, cerebrovascular disease, peripheral vascular disease, congestive heart failure and myocardial infarct between the BAR and 28-day all-cause mortality. Restricted cubic spline analysis revealed a nonlinear association between the BAR and 28-day all-cause mortality (<i>P</i> = 0.003). With BAR ≤ 17.981, each 1-unit increase in the BAR was associated with a 5.7% higher risk of death [95% CI (1.012-1.105), <i>P</i> < 0.05].</p><p><strong>Conclusion: </strong>This study identified a non-linear relationship between the BAR and 28-day all-cause mortality in patients with cardiac arrest.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1609059"},"PeriodicalIF":2.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474469","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 contractility modulation to enhance optimized medical therapy and improve cardiac remodeling in advanced heart failure: a case report.","authors":"Lina Feng, Lina Su, Jingyi Ren","doi":"10.3389/fcvm.2025.1577680","DOIUrl":"10.3389/fcvm.2025.1577680","url":null,"abstract":"<p><strong>Background: </strong>Guideline-directed medical therapy (GDMT) for heart failure (HF) with reduced ejection fraction (HFrEF) has been demonstrated to significantly reduce morbidity and mortality. However, many patients, especially those with advanced HFrEF, are unable to tolerate optimal GDMT due to hypotension. Cardiac contractility modulation (CCM) is a novel therapeutic approach that enhances myocardial contractility and reverses cardiac remodeling, thereby improving cardiac function and quality of life in patients with HFrEF. However, whether CCM can bridge the hemodynamic vulnerability phase to facilitate GDMT optimization and improve patient prognosis remains unclear.</p><p><strong>Case presentation: </strong>A 56-year-old man with dilated cardiomyopathy and HFrEF (<i>N</i>YHA functional class III) had recurrent hospitalizations for HF over the past 4 years. Due to hypotension (systolic blood pressure ≤90 mmHg), the patient was unable to tolerate full-dose GDMT, with sacubitril-valsartan limited to 25 mg twice daily, metoprolol succinate to 23.75 mg once daily, and spironolactone to 20 mg once daily. After a comprehensive evaluation, a CCM device was implanted as the most effective and evidence-based option. Postoperatively, the patient's blood pressure gradually improved, allowing initiation of the four major therapeutic drug classes, which were uptitrated to the maximum tolerated doses. With regular follow-up for 12 months, the patient showed dramatic improvements in exercise capacity and quality of life. More surprisingly, there was significant improvement in cardiac structural and functional remodeling. Echocardiography revealed that left atrioventricular dimensions returned to normal, left ventricular ejection fraction (LVEF) increased from 15% to 48%, and left ventricular global longitudinal strain (GLS) improved from -3.3% to -16.2%. NT-proBNP levels also decreased from 6,553 pg/ml to within the normal range.</p><p><strong>Conclusion: </strong>This case suggests that CCM may serve as a promising strategy to address the issue of poor GDMT tolerance due to hypotension, thereby facilitating GDMT optimization and improving cardiac remodeling patients with HFrEF.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1577680"},"PeriodicalIF":2.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474470","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":"Dynamic change in maternal cardiac function during pregnancy.","authors":"Xiu-Juan Wang, Ling-Ling Chen, Ming-Huan Hong, Ling-Yun Kong, Wei Xiang, Li Fu, Xiao-Wei Li, Fang Liu","doi":"10.3389/fcvm.2025.1577213","DOIUrl":"10.3389/fcvm.2025.1577213","url":null,"abstract":"<p><strong>Background: </strong>Pregnant women experience various physiological changes that, if uncompensated, may result in varying degrees of cardiac dysfunction, and adverse pregnancy outcomes. Left ventricular (LV) global longitudinal strain (GLS) and P-wave to A' duration on tissue Doppler imaging (PA-TDI) have been shown to be able to detect subtle cardiac dysfunction.</p><p><strong>Methods: </strong>The present study was a prospective cross-sectional study. A total of 506 healthy pregnant women were enrolled, including 149 during early pregnancy (before 13 weeks' gestation, T1 group), 99 during mid-pregnancy (14-27 weeks' gestation, T2 group), and 258 during late pregnancy (after 28 weeks' gestation, T3 group), while 172 age- and baseline weight-matched healthy nonpregnant women served as the control group (NPC group). Clinical and echocardiographic data of the subjects were collected. The difference in cardiac structure and function among the 4 groups were analyzed. Multivariate regression analysis was conducted to identify the independent factors influencing change in cardiac function.</p><p><strong>Results: </strong>The median age of the 4 groups were comparable [T1 group, 31.0 (28.5,34.0) years; T2 group, 31.0 (29.0,34.0) years; T3 group, 31.0 (29.0,34.0) years; the NPC group, 31.0 (28.0,34.0) years, <i>P</i> = 0.905). Left ventricular ejection fraction (LVEF) during late pregnancy was lower than that during early pregnancy and the control group, but remained within normal range. With the increase of gestational age, the absolute value of LV-GLS decreased gradually [T1 group, -19.00 (-21.40, -16.70); T2 group, -17.40 (-20.10, -15.30); T3 group, -16.35 (-17.93, -13.97); <i>P</i> < 0.001]. PA-TDI during the third trimester was longer than that in the first [117.65 (108.45,128.03) ms vs. 114.19 (105.61,121.11) ms, <i>P</i> = 0.012] or the second trimester [111.32 (107.27,121.11) ms, <i>P</i> = 0.010]]. Multivariate regression analysis showed that gestational age was independently associated with LV-GLS (<i>b</i> = 0.096, <i>t</i> = 2.212, <i>P</i> = 0.027) and PA-TDI (<i>b</i> = 0.158, <i>t</i> = 2.449, <i>P</i> = 0.014).</p><p><strong>Conclusion: </strong>Pregnant women show a trend toward decreased left ventricular systolic and diastolic function. PA-TDI and LV-GLS can be used to evaluate subtle change in left cardiac function in pregnant women.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1577213"},"PeriodicalIF":2.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474483","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":"Observed and expected overall mortality for acute myocardial infarction during the COVID-19 pandemic in Italy: an analysis of nationwide institutional databases.","authors":"Leonardo De Luca, Francesco Grippo, Paola D'Errigo, Alessandra Burgio, Stefano Rosato, Barbara Giordani, Giorgia Duranti, Giovanni Baglio","doi":"10.3389/fcvm.2025.1540783","DOIUrl":"10.3389/fcvm.2025.1540783","url":null,"abstract":"<p><strong>Aim: </strong>To carry out a nationwide evaluation of both in- and out-of-hospital mortality for acute myocardial infarction (AMI) during the COVID-19 pandemic period in Italy.</p><p><strong>Methods: </strong>This was a retrospective cohort study analysing overall mortality for AMI in Italy during the COVID-19 pandemic (March 1st, 2020-December 31st, 2021) and the previous 5 years (January 1st, 2015-February 29th, 2020). To carefully analyze both in- and out-of-hospital mortality for AMI (with or without concomitant COVID-19 infection) we used different institutional administrative sources of national data. Excess mortality related to AMI during the COVID-19 pandemic has been analyzed using the observed/expected ratio (OER).</p><p><strong>Results: </strong>Over the 5 years pre-pandemic period, 150,299 fatal events related to AMI occurred. During the pandemic, the number of deaths related to AMI was 28,673 in 2020 and declined to 26,688 in 2021. The overall OER was 1.18 [95% confidence intervals (CI): 1.15-1.22] in 2020 and 1.19 (95% CI: 1.15-1.22) while out-of-hospital OER was 1.24 (95% CI: 1.20-1.29) in 2020 and 1.21 (95% CI: 1.16-1.25) during the pandemic. When excluding COVID-19 related deaths, the number of observed in-hospital deaths did not significantly differ from the expected both in 2020 and 2021 while the excess remains unchanged for out-of-hospital mortality.</p><p><strong>Conclusions: </strong>In this analysis of nationwide institutional administrative databases, we documented an increase in observed mortality compared to the expected during the COVID-19 pandemic in Italy. This mortality increase is mainly attributable to out-of-hospital fatal events and related to concomitant COVID-19 infection for hospitalized AMI patients.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1540783"},"PeriodicalIF":2.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474488","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}