Frontiers in Cardiovascular Medicine最新文献

{"title":"Case Report: Extrapulmonary tuberculosis presenting as multiple caseous pericardial masses.","authors":"Juan Wang, Run Zhang, Zhengliang Li, Hui Fang, Wenzhong Zhang","doi":"10.3389/fcvm.2025.1529400","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1529400","url":null,"abstract":"<p><p>The diagnosis of tuberculous pericarditis presenting as a hemorrhagic pericardial effusion is not difficult to make, but the presence of multiple pericardial masses in tuberculous pericarditis is uncommon. The article reports a 55-year-old Asian woman with a 10-day history of fever, chest tightness and shortness of breath. Laboratory investigations revealed an elevated C-reactive protein and erythrocyte sedimentation rate, and echocardiography showed a small amount of pericardial effusion associated with multiple pericardial caseous masses (up to approximately 2.4 cm × 6.9 cm) without pericardial constriction. Ten ml of bloody pericardial effusion was punctured and sent for pathology without malignant cells, and malignant mesothelioma was excluded in combination with PET-CT results. The diagnosis of extrapulmonary tuberculosis was finally confirmed by a positive Mantoux test and positive tuberculosis immunoreactivity, and the patient is now receiving standardized anti-tuberculosis treatment in a specialist hospital. Nowadays, the diagnosis of tuberculous pericarditis is not difficult, but the symptoms of a concomitant giant mass are rare, and its nature and treatment options (including drugs or surgery) are worth exploring.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1529400"},"PeriodicalIF":2.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076923","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 of illness perception and related factors with treatment adherence among chronic hemodialysis patients with cardio-renal syndrome in Yemen.","authors":"Adel Omar Laradhi, Yan Shan, Abdulaziz Mansoor Al Raimi, Nahed Ahmed Hussien, Eman Ragab, Mikiyas Amare Getu, Galal Al-Bani, Mohamed Elsayed Allawy","doi":"10.3389/fcvm.2025.1432648","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1432648","url":null,"abstract":"<p><strong>Background: </strong>Patients' illness perceptions are cognitive representations or beliefs structured around their condition. These perceptions have been associated with several important outcomes, including functional recovery and treatment adherence.</p><p><strong>Objective: </strong>The aim of this study was to investigate the association between illness perception and related factors with treatment adherence among hemodialysis patients with cardio-renal syndrome in Yemen.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at two dialysis centers in Hadhramout Governorate, Yemen, from February to May 2021. Three self-administered questionnaires were used to collect the data. Data analysis was performed using SPSS version 23.0 with a significance level set at <i>p</i> < 0.05.</p><p><strong>Results: </strong>In total, 100 patients answered all questions with a total response rate of 100%. The mean age ± standard deviation of participants was 53.46 ± 14.24 years. Most patients (87%) had a low level of treatment adherence, particularly in medication and diet restriction adherence. Furthermore, most patients (90%) had a moderate-to-high level of perceived illness threat. The findings revealed no significant correlation between overall illness perception and overall treatment adherence (<i>r</i> = 0.003, <i>p</i> = 0.975). However, the perceived consequences (<i>r</i> = -0.210, <i>p</i> < 0.05), and perceived timeline subscales (<i>r</i> = -0.276, <i>p</i> < 0.01) showed a negative correlation with total treatment adherence. Additional findings revealed a significant positive link between adherence and cardiac disorders (<i>β</i> = 4.292, <i>p</i> = 0.009), as well as a strong correlation between adherence and income level (<i>β</i> = 11.132, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Our research found that most patients with cardio-renal syndrome had poor treatment adherence and had a moderate-to-high level of perceived illness threat. The results of the study showed that perceived consequences and perceived timeline subscales of illness perceptions had a negative correlation with overall treatment adherence, and the results revealed a significant positive link between adherence and cardiac disorders, as well as a strong correlation between adherence and income level. The findings suggest that nurses and clinicians should assess the illness perceptions specific to patients with cardio-renal syndrome disease when developing multidisciplinary interventions to help patients cope with and manage different aspects of their condition.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1432648"},"PeriodicalIF":2.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12075227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077017","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":"Circulating growth differentiation factor-15 concentration and hypertension risk: a dose-response meta-analysis.","authors":"Zhengqing Yu, Jianshu Gao, Zhongwei Zhou, Li Li, Sanqiang Hu","doi":"10.3389/fcvm.2025.1500882","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1500882","url":null,"abstract":"<p><strong>Background: </strong>Growing evidence suggests that growth differentiation factor-15 (GDF-15) may contribute to adverse clinical outcomes, such as major cardiovascular events and all-cause mortality. However, there is little information about its relationship to hypertension. This meta-analysis aimed to quantitatively evaluate the relationship between circulating GDF-15 and hypertension prevalence.</p><p><strong>Methods: </strong>Databases searched included PubMed, Web of Science, and Embase, from inception to August 2024. The inclusion criteria were studies reporting hypertension prevalence in at least three GDF-15 categories.</p><p><strong>Result: </strong>A total of 24 studies from 21 articles with 35,904 participants and 23,925 hypertensive cases were included in this meta-analysis. Compared with individuals with a low level of circulating GDF-15, those with high GDF-15 level had a higher prevalence of hypertension [odds ratios (OR) 1.60, 95% confidence interval (CI) 1.37-1.88, <i>P</i> < 0.001). In the dose-response meta-analysis, the prevalence of hypertension increased by 24% with every 1 ng/ml increase in GDF-15 (OR 1.24, 95% CI 1.16-1.33, <i>P</i> < 0.001). However, the dose-response curve was nonlinear (<i>P</i>-nonlinearity < 0.001), plateauing or even decreasing slightly after GDF-15 concentrations reached approximately 5.5 ng/ml. Significant heterogeneity was detected in the pooled analysis and meta-regression analysis suggested that participants' age and the prevalence of diabetes significantly accounted for the heterogeneity.</p><p><strong>Conclusions: </strong>Circulating GDF-15 is positively and non-linearly associated with the prevalence of hypertension, with a plateau or slight decline after reaching a certain GDF-15 dose. <b>Systematic Review Registration:</b> https://inplasy.com/inplasy-2023-3-0082/, identifier (INPLASY202330082).</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1500882"},"PeriodicalIF":2.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12075195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076925","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":"Isotropic, high-resolution, whole-chest inversion recovery contrast-enhanced magnetic resonance angiography in under 4.5 min using image-based navigator fluoro trigger.","authors":"Jason Craft, Roosha Parikh, Josh Y Cheng, Nancy Diaz, Karl P Kunze, Michaela Schmidt, Radhouene Neji, Amanda Leung, Suzanne Weber, Jonathan Weber, Timothy Carter, Sylvia Biso, Ann-Marie Yamashita, Eric H Wolff, Claudia Prieto, Rene M Botnar","doi":"10.3389/fcvm.2025.1549275","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1549275","url":null,"abstract":"<p><strong>Background: </strong>Serial assessment of the thoracic aorta with magnetic resonance angiography (MRA) is desirable due to 3D volumetric dataset, high spatial resolution, and lack of ionizing radiation. Electrocardiogram (ECG) gated, contrast-enhanced (CE), inversion recovery gradient echo MRA is efficient and historically provides low artifact burden, but the window for imaging with weak albumin binding extracellular gadolinium based contrast agents is small. Our purpose was to acquire whole-chest gated CE-MRA with 1.2 mm³ resolution using image-based navigator (iNAV) for motion correction/contrast monitoring, and variable density sampling in 4-5 min. Image quality and vessel diameter reproducibility are assessed against time resolved MRA (TR-MRA).</p><p><strong>Methods: </strong>iNAV CE-MRA and TR-MRA were obtained prospectively in 40 patients and reviewed by 3 blinded cardiologists for vessel diameter and image quality rated on a four point scale: (1) non-diagnostic; (2) poor-significant blurring; (3) good-mild blurring; and (4) excellent. Reproducibility and image quality were evaluated using the concordance correlation statistic and Cohen's kappa with mean differences evaluated using paired <i>t</i>-tests and repeat-measures ANOVA.</p><p><strong>Results: </strong>iNAV CE-MRA scan time was 4.2 ± 0.7 min. iNAV CE-MRA quality score was higher (<i>p</i> < .001); average difference was 1.4 ± .08 at the sinus of Valsalva (SOV), 1.3 ± .08 at the sinotubular junction (STJ), and .87 ± .10 at the ascending aorta (AAO). Major/minor diameter interobserver agreement was better for iNAV CE-MRA (SOV ICC = .87-.93; STJ ICC = .95-.96; AAO ICC = .96-.97) vs. TR-MRA (SOV ICC = .69-.82; STJ ICC = .78-.83; AAO ICC = .89), as was intraobserver agreement (SOV ICC = .93-.95; STJ ICC = .94-.96; AAO ICC = .96-.97) vs. TR-MRA (SOV ICC = .81-.88; STJ ICC = .72-.73; AAO ICC = .87-.93).</p><p><strong>Conclusion: </strong>iNAV CE-MRA is feasible within a clinically reasonable scan time, provides superior image quality, and measurement reproducibility vs. TR-MRA.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1549275"},"PeriodicalIF":2.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12075228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076988","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":"Similar burden of rare genetic variants in ischemic and non-ischemic dilated cardiomyopathy.","authors":"Louie Cao, Joshua Rushakoff, Ian Williamson, Anja Karlstaedt, Michelle Kittleson, Lawrence Czer, Evan P Kransdorf","doi":"10.3389/fcvm.2025.1542653","DOIUrl":"10.3389/fcvm.2025.1542653","url":null,"abstract":"<p><strong>Background: </strong>The aim of the study was to determine the prevalence of rare disease-causing variants in cardiomyopathy-associated genes in a cohort of patients with ischemic and non-ischemic dilated cardiomyopathy undergoing heart transplant.</p><p><strong>Methods: </strong>We conducted a single-center cohort study of 60 adult patients with left ventricular ejection fraction ≤50% and left ventricular end-diastolic dimension ≥95th percentile for sex/height who underwent heart transplant between January 2017 and December 2023 and consented to participate in a cardiac tissue biobank. We evaluated the prevalence of rare (minor allele frequency <0.1%) disease-causing (pathogenic or likely pathogenic by American College of Genetics and Genomics criteria) variants in cardiomyopathy-associated genes.</p><p><strong>Results: </strong>A total of 60 individuals fulfilled the inclusion criteria: 16 with ischemic dilated cardiomyopathy [88% men, median age 65 years, interquartile range (IQR) 64-68 years] and 44 with non-ischemic dilated cardiomyopathy (80% men, median age 53 years, IQR 39-65 years). We found that the prevalence of disease-causing variants was similar between patients with ischemic dilated cardiomyopathy (3/16 or 19%; 95% credible interval 6%-36%) and those with non-ischemic dilated cardiomyopathy (10/44 or 23%; 95% credible interval 12%-33%). Variants in the ischemic dilated cardiomyopathy group were found in the <i>TTN</i> and <i>DMD</i> genes. Variants in the non-ischemic dilated cardiomyopathy group were found in the <i>TTN</i>, <i>FLNC</i>, <i>LMNA</i>, <i>MYH7</i>, and <i>RBM20</i> genes.</p><p><strong>Conclusions: </strong>Patients with ischemic dilated cardiomyopathy undergoing heart transplant possessed a similar burden of rare disease-causing variants as those with non-ischemic dilated cardiomyopathy. Our results suggest that genetic testing may be beneficial in patients with advanced heart failure requiring heart transplant due to ischemic dilated cardiomyopathy to detect disease-causing variants in cardiomyopathy-associated genes.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1542653"},"PeriodicalIF":2.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983057","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 effect of WeChat-based brisk walking on kinesiophobia in patients after percutaneous coronary intervention: a randomised controlled trial.","authors":"Bo-Ya Wan, Ce Zhou, Xing Sun, Feng-Min Yu, Mei-Xia Liu, Jia-Yuan Zhang, Qi Li, Li Zhang","doi":"10.3389/fcvm.2025.1416356","DOIUrl":"10.3389/fcvm.2025.1416356","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to evaluate the benefit of a home-based cardiac rehabilitation (CR) programme with telemonitoring guidance on kinesiophobia in patients with percutaneous coronary intervention (PCI) discharged from hospital. It also aimed to explore the effectiveness of this programme on self-efficacy and cardiorespiratory endurance using a randomised controlled trial.</p><p><strong>Design: </strong>This study was a single-blind, prospective randomised controlled trial.</p><p><strong>Methods: </strong>Patients who underwent PCI at our hospital were enrolled. The intervention group (IG) performed WeChat-based brisk walking and the control group (CG) received the usual care, including advice to remain physically active. All patients underwent cardiopulmonary exercise testing to assess their peak oxygen uptake (peak VO₂) at baseline and after a 12-week intervention period. The main outcome indicator was kinesiophobia. Secondary outcomes included exercise self-efficacy, cardiorespiratory endurance (i.e., peak VO₂), and major adverse cardiovascular events.</p><p><strong>Results: </strong>A total of 137 patients were enrolled in this study between 1 February 2023 and 31 October 2023. Of them, 130 patients successfully completed a 12-week WeChat-based brisk walking CR programme. After 12 weeks of intervention, the Tampa Scale for Kinesiophobia Heart scores in the IG decreased significantly more than in the CG and pre-IG. The IG's Self-Efficacy for Exercise scores were higher than those of the CG and pre-IG. In addition, the increase in peak VO₂ was larger in the IG than in the CG.</p><p><strong>Conclusion: </strong>The WeChat-based brisk walking programme is beneficial for reducing kinesiophobia by increasing exercise self-efficacy in patients after PCI; it also helps to improve cardiopulmonary endurance. WeChat-based brisk walking is feasible and acceptable.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1416356"},"PeriodicalIF":2.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975109","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":"Aortic angiosarcoma leading to paraplegia: a case report.","authors":"Jing Li, Jiubo Sun","doi":"10.3389/fcvm.2025.1551262","DOIUrl":"10.3389/fcvm.2025.1551262","url":null,"abstract":"<p><strong>Background: </strong>Aortic angiosarcoma is a rare disease with atypical clinical symptoms. It often initially presents with embolic phenomena, such as lower limb arterial embolism, visceral embolism, or cerebral embolism, or as renovascular hypertension.</p><p><strong>Methods: </strong>There are no reported cases in the literature of spinal cord embolism caused by this condition. We report a case of a 76-year-old female patient whose abdominal CT showed a soft tissue mass in the left hip, involving the sacrum and iliac bone.</p><p><strong>Results: </strong>Aortic CTA revealed irregular filling defects in the aortic arch and descending aorta, highly suggestive of a tumor. A biopsy of the left hip mass confirmed the diagnosis of angiosarcoma. Immunohistochemistry results were positive for Vimentin, CD31, and ERG. Based on the patient's CTA findings, a diagnosis of aortic angiosarcoma with left hip soft tissue metastasis was made. The patient developed paraplegia and lower limb arterial embolism and died shortly afterward. This article briefly reviews the literature on aortic angiosarcoma.</p><p><strong>Conclusions: </strong>The purpose of this case report is to highlight the importance of monitoring common embolic sites in clinical practice, while also considering the possibility of rare sites, such as spinal cord embolism.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1551262"},"PeriodicalIF":2.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002971","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 risk stratification model for coronary artery lesions in Kawasaki disease: focus on subgroup-specific utility.","authors":"Chuxiong Gong, Zhongjian Su, Qinhong Li, Hongyan Li, Ziyu Wang, Huiing Gao, Yamin Li, Xiaomei Liu, Lili Deng","doi":"10.3389/fcvm.2025.1543767","DOIUrl":"10.3389/fcvm.2025.1543767","url":null,"abstract":"<p><strong>Objective: </strong>Kawasaki disease is an acute immune vasculitis that often has a poor prognosis when complicated by coronary artery lesions. Our study aims to construct a risk model for Kawasaki disease complicated by coronary artery lesions and validate it in different clinical characteristic subgroups, optimizing personalized and precise management of Kawasaki disease to improve patient outcomes.</p><p><strong>Methods: </strong>First, we compared each factor between the groups with and without coronary artery damage. We then used LASSO analysis to further filter for factors that were more significant in predicting outcomes. The selected factors were used to construct the risk model. The model was evaluated using ROC curves, calibration curves, and DCA, and was internally validated using 5-fold cross-validation. Finally, we also conducted subgroup analyses based on factors such as age stages and sex.</p><p><strong>Results: </strong>Through univariate analysis, LASSO analysis, and correlation analysis, we identified WBC, PLT, CRP, ALB, Na, Time to IVIG treatment, and symptoms of limb as the key factors for constructing the risk model. The model achieved an area under the curve of 0.815(95%CI: 0.779-0.851). Additionally, calibration curves, DCA, and 10-fold cross-validation demonstrated that the model has good predictive performance. The predictive efficacy of the model was also satisfactory across various subgroups.</p><p><strong>Conclusions: </strong>Our study has constructed a risk model for Kawasaki disease complicated by coronary artery lesions in the Chinese population that demonstrates good predictive performance, and it has been validated successfully across multiple subgroups.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1543767"},"PeriodicalIF":2.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964684","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 multi-center, randomized, double-blind, placebo-controlled trial to evaluate the efficacy and safety of Fuzheng Yangxin Granule in treating heart failure with preserved ejection fraction (Qi-Yin deficiency and blood stasis syndrome): study protocol.","authors":"Jingjing Chen, Zian Yan, Jiacong Wang, Lijun Guo, Zhonghui Jiang, Fangfang Wang, Ruina Bai, Xiaochang Ma","doi":"10.3389/fcvm.2025.1514181","DOIUrl":"10.3389/fcvm.2025.1514181","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure with preserved ejection fraction (HFpEF) is a widespread public health issue worldwide. Despite recent advances in pharmacologic treatments and the introduction of new diagnostic approaches, HFpEF remains underdiagnosed and under-recognized in clinical practice. Traditional Chinese medicine (TCM) may offer a potentially effective treatment for HFpEF. Nevertheless, few clinical trials employ rigorous research methodologies to evaluate the efficacy and safety of TCM in treating HFpEF. Consequently, we propose to assess the hypothesis that patients with HFpEF may benefit from Fuzheng Yangxin Granule (FZYX) and evaluate its safety in a rigorously designed clinical trial.</p><p><strong>Methods: </strong>This multicenter, double-blind, randomized controlled trial will be conducted across seven tertiary hospitals in China. We will enroll 150 participants aged 18-80 years with confirmed HFpEF (Qi-Yin deficiency and blood stasis syndrome) meeting inclusion criteria. Participants will be randomly assigned (1:1) to the FZYX group or the placebo group, ​with both groups receiving standardized Western medical therapy according to the National Heart Failure Guideline 2023. The 12-week intervention phase will be followed by 40-week safety follow-up. The primary outcome will be maximal peak oxygen uptake (peak VO₂). Secondary outcomes will include composite endpoint events, all-cause mortality, 6-minute walking distance (6MWD), New York Heart Association (NYHA) functional class, serum N-terminal pro-B-type natriuretic peptide (NT-proBNP), echocardiographic variables, Minnesota Living with Heart Failure Questionnaire (MLHFQ) score, TCM syndrome scores, and the FRAIL scale.</p><p><strong>Discussion: </strong>The objective of this study is to evaluate the efficacy and safety of FZYX in treating HFpEF (Qi-Yin deficiency and blood stasis syndrome), thereby providing a high-quality, reliable evidence-based foundation for clinical practice.</p><p><strong>Clinical trial registration: </strong>China Clinical Trial Registry (ChiCTR2400087293), Registered on July 24, 2024.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1514181"},"PeriodicalIF":2.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983668","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":"Development and validation of a nomogram for predicting survival in patients with cardiogenic shock.","authors":"Dingfeng Fang, Huihe Chen, Hui Geng, Xiahuan Chen, Meilin Liu","doi":"10.3389/fcvm.2025.1538395","DOIUrl":"10.3389/fcvm.2025.1538395","url":null,"abstract":"<p><strong>Background: </strong>There is currently a lack of easy-to-use tools for assessing the severity of cardiogenic shock (CS) patients. This study aims to develop a nomogram for evaluating severity in CS patients regardless of the underlying cause.</p><p><strong>Methods and results: </strong>The MIMIC-IV database was used to identify 1,923 CS patients admitted to the ICU. A multivariate Cox model was developed in the training cohort (70%) based on LASSO regression results. Factors such as age, systolic blood pressure, arterial oxygen saturation, hemoglobin, serum creatinine, blood glucose, arterial pH, arterial lactate, and norepinephrine use were incorporated into the final model. This model was visualized as a Cardiogenic Shock Survival Nomogram (CSSN) to predict 30-day survival rates. The model's c-statistic was 0.75 (95% CI: 0.73-0.77) in the training cohort and 0.73 (95% CI: 0.70-0.77) in the validation cohort, demonstrating good predictive accuracy. The AUC of the CSSN for 30-day survival probabilities was 0.76 in the training cohort and 0.73 in the validation cohort. Calibration plots showed strong concordance between predicted and actual survival rates, and decision curve analysis (DCA) affirmed the model's clinical utility. The CSSN outperformed the Cardiogenic Shock Score (CSS) in various metrics, including c-statistic, time-dependent ROC, calibration plots, and DCA (c-statistic: 0.75 vs. 0.72; AUC: 0.76 vs. 0.73, <i>P</i> < 0.01 by Delong test). Subgroup analysis confirmed the model's robustness across both AMI-CS and non-AMI-CS subgroups.</p><p><strong>Conclusions: </strong>The CSSN was developed to predict 30-day survival rates in CS patients irrespective of the underlying cause, showing good performance and potential clinical utility in managing CS.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1538395"},"PeriodicalIF":2.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991088","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}