Frontiers in Cardiovascular Medicine最新文献

{"title":"From knowledge silos to integrated insights: building a cardiovascular medication knowledge graph for enhanced medication knowledge retrieval, relationship discovery, and reasoning.","authors":"Hongzhen Cui, Xiaoyue Zhu, Wei Zhang, Meihua Piao, Yunfeng Peng","doi":"10.3389/fcvm.2025.1526247","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1526247","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases are diverse, intersecting, and characterized by multistage complexity. The growing demand for personalized diagnosis and treatment poses significant challenges to clinical diagnosis and pharmacotherapy, increasing potential medication risks for doctors and patients. The Cardiovascular Medication Guide (CMG) demonstrates distinct advantages in managing cardiovascular disease, serving as a critical reference for front-line doctors in prescription selection and treatment planning. However, most medical knowledge remains fragmented within written records, such as medical files, without a cohesive organizational structure, leading to an absence of clinical support from visualized expert knowledge systems.</p><p><strong>Purpose: </strong>This study aims to construct a comprehensive Expert Knowledge Graph of Cardiovascular Medication Guidelines (EKG-CMG) by integrating unstructured and semi-structured Cardiovascular Medication Knowledge (CMK), including clinical guidelines and expert consensus, to create a visually integrated cardiovascular expert knowledge system.</p><p><strong>Methods: </strong>This study utilized consensus and guidelines from cardiovascular experts to organize and manage structured knowledge. BERT and knowledge extraction techniques capture drug attribute relationships, leading to the construction of the EKG-CMG with fine-grained information. The Neo4j graph database stores expert knowledge, visualizes knowledge structures and semantic relationships, and supports retrieval, discovery, and reasoning of knowledge about medication. A hierarchical-weighted, multidimensional relational model to mine medication relationships through reverse reasoning. Experts participated in an iterative review process, allowing targeted refinement of expert medication knowledge reasoning.</p><p><strong>Results: </strong>We construct an ontology encompassing 12 cardiovascular \"medication types\" and their \"attributes of medication types\". Approximately 15,000 entity-relationships include 22,475 medication entities, 2,027 entity categories, and 3,304 relationships. Taking beta-blockers (β) as an example demonstrates the complete process of ontology to knowledge graph construction and application, encompassing 41 AMTs, 1,197 entity nodes, and 1,351 relationships. The EKG-CMG can complete knowledge retrieval and discovery linked to \"one drug for multiple uses,\" \"combination therapy,\" and \"precision medication.\" Additionally, we analyzed the knowledge reasoning case of cross-symptoms and complex medication for complications.</p><p><strong>Conclusion: </strong>The EKG-CMG systematically organizes CMK, effectively addressing the \"knowledge island\" issues between diseases and drugs. Knowledge potential relationships have been exposed by leveraging EKG-CMG visualization technology, which can facilitate medication semantic retrieval and the exploration and reasoning of complex knowledge relationships.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1526247"},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975476","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":"Retrograde inferior vena cava perfusion reduces the risk of acute kidney injury depending on the oxygen extraction ratio. A retrospective cohort study.","authors":"Xinyi Liao, Dan Luo, Jing Lin, Zhaoxia Tan, Jiyue Xiong, Lei Du","doi":"10.3389/fcvm.2025.1514247","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1514247","url":null,"abstract":"<p><strong>Background: </strong>Total aortic arch replacement surgery (TARS) for Acute type A aortic dissection is associated with high incidence of postoperative acute kidney injury (AKI), at least partly due to the lower body ischemia during circulatory arrest. This study aimed to evaluate whether retrograde inferior vena cava perfusion (RIVP) reduces the risk of AKI by providing oxygenated blood to the lower body.</p><p><strong>Methods: </strong>This retrospective study utilized a medical recording system to screen patients who underwent TARS from January 1 to December 31, 2019. Patients were assigned to receive antegrade cerebral perfusion (ACP) only or ACP + RIVP during circulatory arrest. The primary outcome was postoperative AKI. Oxygen delivery, consumption, and extraction ratio during RIVP were also determined.</p><p><strong>Results: </strong>Of all included 87 patients, postoperative AKI occurred in 35 (40%), of whom 23 (53.5%) were in the ACP, and 12 (27.3%) were in the ACP + RIVP (<i>P</i> = 0.013). In regression analysis, ACP + RIVP was associated with lower risk of AKI than ACP alone (adjusted OR 0.229; 95% CI 0.071-0.746). RIVP at a pressure of 22.5 ± 3.8 mmHg delivered 0.98 ± 0.34 ml/min/kg of oxygen to the lower body, and the partial oxygen pressure decreased from 359 ± 57 mmHg in RIVP blood to 64 ± 30 mmHg in returning blood. Oxygen extraction ratio was 44 ± 16%, which correlated negatively with peak postoperative creatinine levels (<i>r</i> = -0.58, <i>P</i> = 0.01) and creatinine increase (<i>r</i> = -0.61, <i>P</i> = 0.009). No correlations were found between oxygen delivery and postoperative creatinine or creatinine increase.</p><p><strong>Conclusion: </strong>RIVP may reduce the risk of postoperative AKI in a manner that depends on the tissue oxygen extraction ratio.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1514247"},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002699","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":"Current state of heart failure treatment: are mesenchymal stem cells and their exosomes a future therapy?","authors":"Chengqian Chen, Wentao Zhong, Hao Zheng, Wei Zhao, Yushi Wang, Botao Shen","doi":"10.3389/fcvm.2025.1518036","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1518036","url":null,"abstract":"<p><p>Heart failure (HF) represents the terminal stage of cardiovascular disease and remains a leading cause of mortality. Epidemiological studies indicate a high prevalence and mortality rate of HF globally. Current treatment options primarily include pharmacological and non-pharmacological approaches. With the development of mesenchymal stem cell (MSC) transplantation technology, increasing research has shown that stem cell therapy and exosomes derived from these cells hold promise for repairing damaged myocardium and improving cardiac function, becoming a hot topic in clinical treatment for HF. However, this approach also presents certain limitations. This review summarizes the mechanisms of HF, current treatment strategies, and the latest progress in the application of MSCs and their exosomes in HF therapy.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1518036"},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009688","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 singing on vascular health in older adults with coronary artery disease: a randomized, crossover trial.","authors":"Mehri Bagherimohamadipour, Muhammad Hammad, Alexis Visotcky, Rodney Sparapani, Jacquelyn Kulinski","doi":"10.3389/fcvm.2025.1546462","DOIUrl":"10.3389/fcvm.2025.1546462","url":null,"abstract":"<p><strong>Background: </strong>The impact of singing on cardiovascular health has not been extensively studied. The aim of this study is to investigate the effect of singing on cardiovascular biomarkers in an aging population with coronary artery disease (CAD).</p><p><strong>Methods: </strong>Participants had three study visits separated by 2-7 days, according to a randomized, researcher-blinded, crossover, controlled design: (1) a 30-min period of live singing with an in-person music therapist, (2) a 30-min period of singing along to an instructional video and (3) a 30-min rest (control). Primary outcomes included macrovascular endothelial function assessed by brachial artery flow-mediated dilation and microvascular function assessed by peripheral arterial tonometry [Framingham reactive hyperemia index (fRHI) and reactive hyperemia index (RHI)]. Heart rate variability (HRV) was a secondary outcome.</p><p><strong>Results: </strong>Sixty-five subjects (mean age 67.7 ± 0.8 years, 40% female) completed the study. Compared to control, there was an increase in fRHI for the singing video intervention (estimate: 0.54, SE: 0.19, <i>p</i> = 0.005) but not for the live singing intervention (estimate: 0.11, SE: 0.18, <i>p</i> = 0.570). There was no change in macrovascular function with either intervention. The low frequency/high frequency (LF/HF) ratio increased by 2.80 (SE: 1.03, <i>p</i> = 0.008), and the natural logarithm of high frequency (LnHF) power decreased by -0.90 ms² (SE: 0.29, <i>p</i> = 0.003) with the video (during to pre-change). When assessing post- to pre- change, the live singing intervention showed a significant change of -0.62 ms² (SE 0.29, <i>p</i> = 0.036) in LnHF power.</p><p><strong>Conclusions: </strong>Singing along to an instructional video for 30 min improved microvascular, but not macrovascular, endothelial function, in older patients with CAD. HRV changes with singing are similar to that of exercise.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov, identifier (NCT04121741).</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1546462"},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983129","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":"Cell cycle arrest of cardiomyocytes in the context of cardiac regeneration.","authors":"Qingling Xu, Xinhui Chen, Chunyige Zhao, Ying Liu, Jianxun Wang, Xiang Ao, Wei Ding","doi":"10.3389/fcvm.2025.1538546","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1538546","url":null,"abstract":"<p><p>The limited capacity of adult mammalian cardiomyocytes to undergo cell division and proliferation is one of the key factors contributing to heart failure. In newborn mice, cardiac proliferation occurs during a brief window, but this proliferative capacity diminishes by 7 days after birth. Current studies on cardiac regeneration focused on elucidating changes in regulatory factors within the heart before and after this proliferative window, aiming to determine whether potential association between these factors and cell cycle arrest in cardiomyocytes. Facilitating the re-entry of cardiomyocytes into the cell cycle or reversing their exit from it represents a critical strategy for cardiac regeneration. This paper provides an overview of the role of cell cycle arrest in cardiac regeneration, briefly describes cardiomyocyte proliferation and cardiac regeneration, and systematically summarizes the regulation of the cell cycle arrest in cardiomyocytes, and the potential metabolic mechanisms underlying cardiomyocyte cycle arrest. Additionally, we highlight the development of cardiovascular disease drugs targeting cardiomyocyte cell cycle regulation and their status in clinical treatment. Our goal is to outline strategies for promoting cardiac regeneration and repair following cardiac injury, while also pointing toward future research directions that may offer new technologies and prospects for treating cardiovascular diseases, such as myocardial infarction, arrhythmia and heart failure.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1538546"},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062689","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 cGAS-STING pathway in atherosclerosis.","authors":"Si-Yu Wang, Yu-Shan Chen, Bo-Yuan Jin, Ahmad Bilal","doi":"10.3389/fcvm.2025.1550930","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1550930","url":null,"abstract":"<p><p>Atherosclerosis (AS), a chronic inflammatory disease, remains a leading contributor to cardiovascular morbidity and mortality. Recent studies highlight the critical role of the cGAS-STING pathway-a key innate immune signaling cascade-in driving AS progression. This pathway is activated by cytoplasmic DNA from damaged cells, thereby triggering inflammation and accelerating plaque formation. While risk factors such as aging, obesity, smoking, hypertension, and diabetes are known to exacerbate AS, emerging evidence suggests that these factors may also enhance cGAS-STING pathway, which amplifies inflammatory responses. Targeting this pathway offers a promising therapeutic strategy to reduce the burden of cardiovascular diseases (CVD). In this review, we summarize the mechanisms of the cGAS-STING pathway, explore its role in AS, and evaluate potential inhibitors as future therapeutic candidates. By integrating current knowledge, we aim to provide insights for developing novel treatments to mitigate AS and CVD burden.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1550930"},"PeriodicalIF":2.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959078","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":"Advances in diagnosis, management, and long-term outcomes of pediatric vasovagal syncope: a comprehensive review.","authors":"Wenjing Zhu, Xueyan Bian, Jianli Lv","doi":"10.3389/fcvm.2025.1481749","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1481749","url":null,"abstract":"<p><p>Vasovagal syncope (VVS) is the most common cause of transient loss of consciousness in children and adolescents, accounting for 60%-80% of syncope cases. This review synthesizes current evidence on pediatric VVS, focusing on advances in diagnosis, management, and long-term outcomes. Through a comprehensive literature search of studies published between 2001 and 2024, we analyzed epidemiological patterns, pathophysiological mechanisms, diagnostic approaches, management strategies, and prognostic factors. Recent diagnostic advances include implantable loop recorders and smartphone applications, which have improved diagnostic accuracy. Management has evolved toward individualized approaches, emphasizing non-pharmacological interventions (hydration, salt supplementation, physical counterpressure maneuvers) as first-line treatment, with medications such as midodrine and fludrocortisone showing variable efficacy in refractory cases. Long-term studies indicate that while most children experience improvement over time, 33%-50% have recurrent episodes within three years, with factors such as lower mean arterial pressure, higher urine specific gravity, younger age, family history of syncope, and lower body mass index associated with increased recurrence risk. Though generally benign, VVS can significantly impact quality of life and carries substantial psychosocial consequences. Future research should focus on developing predictive models for recurrence risk and exploring personalized treatment approaches to improve outcomes.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1481749"},"PeriodicalIF":2.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972344","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":"Baduanjin exercise improves functional capacity and cardiovascular function in older adults with cardiovascular diseases: a systematic review and meta-analysis.","authors":"Xingyu Hu, Yiran Li, Haiyun Jiang, Zhihao Luo, Zengqing, Jihua Zou, Xiaoyan Zheng","doi":"10.3389/fcvm.2025.1419095","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1419095","url":null,"abstract":"<p><strong>Background: </strong>Based on clinical observations and expert recommendations, Baduanjin exercise has demonstrated a positive impact on maintaining and enhancing cardiovascular function. Despite clinical observations of Baduanjin's cardiovascular benefits, systematic evidence for older adults remains limited. Moreover, the effects of Baduanjin exercise on functional capacity in older adults with cardiovascular diseases have not been adequately investigated. Therefore, we conducted a systematic review and meta-analysis to evaluate the overall efficacy and effectiveness of Baduanjin exercise on functional capacity and cardiovascular function in older adults with cardiovascular diseases.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis, searching related trials through March 7, 2025, across six databases: PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, and China Science Journal Database (VIP). Methodological quality was assessed using the Cochrane Risk of Bias Tool, and a meta-analysis of comparative effects was performed using Review Manager v.5.3 software.</p><p><strong>Results: </strong>A total of 26 randomized controlled trials involving 2,080 participants were included in this meta-analysis. The results indicate that Baduanjin exercise significantly enhances functional capacity as measured by 6MWT compared to the control group (MD: 41.75, 95% CI: 33.08-50.42, <i>p</i> < 0.00001, <i>I</i> ² = 85%), and improves cardiovascular health markers including LVEF (MD: 5.04, 95% CI: 3.40-6.68, <i>p</i> < 0.00001, <i>I</i> ² = 82%). In dose-subgroup analysis, moderate exercise intensity (30-60 min per time) significantly improved cardiovascular function compared with those of the control group (MD: 56.36, 95% CI: 41.49-71.24, <i>p</i> < 0.00001, <i>I</i> ² = 92%). The secondary outcomes also demonstrated benefits in cardiac remodeling indices, including reductions LVESD (MD: -1. 67, 95% CI: -2.76 to -0.59, <i>p</i> = 0.002, <i>I</i> ² = 95%), LVDD (MD: -2.38, 95% CI: -3.59 to -1.17, <i>p</i> = 0.0001, <i>I</i> ² = 93%). In addition, Baduanjin exercise improved blood biomarkers such as NT-proBNP (MD: -183.83, 95% CI: -309.83 to -57.83, <i>p</i> < 0.00001, <i>I</i> ² = 82%) and NO (MD: 3.54, 95% CI: 1.74-5.34, <i>p</i> = 0.0001, <i>I</i> ² = 0%). What's more, it also decreased MLHFQ (MD: -7.00, 95% CI: -9.54 to -4.45, <i>p</i> = 0.0003, <i>I</i> ² = 79%).</p><p><strong>Conclusions: </strong>Moderate-intensity Baduanjin (30-60 min/session) significantly improved 6MWT distance and cardiac function parameters by LVEF, LVESD, and LVDD, etc.</p><p><strong>Systematic review registration: </strong>identifier, PROSPERO registration number: (CRD42023477008).</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1419095"},"PeriodicalIF":2.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983105","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 triglyceride-glucose-related indices with adverse clinical outcomes in individuals with normal body mass index.","authors":"Jiejie Xie, Xiong Pei, Shixuan Zhu, Wei Jiang, Hong Tang, Dongbo Wu, Yan Xie","doi":"10.3389/fcvm.2025.1570239","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1570239","url":null,"abstract":"<p><strong>Background and aims: </strong>The triglyceride-glucose (TyG) index serves as a reliable indicator of insulin resistance and metabolic risk factors. Most research has focused on obese individuals, with limited exploration in those with a normal body mass index (BMI).</p><p><strong>Method: </strong>This study analyzed 4,440 adults with normal BMI from NHANES 2003-2018. Logistic regression, linear regression, subgroup analysis, and survival analysis examined the relationship between TyG-related indices (TyG, TyG-BMI, TyG-WC, TyG-WHtR) and outcomes like liver fibrosis, stroke, cardiovascular disease (CVD), and mortality.</p><p><strong>Results: </strong>In 4,440 individuals, 279 developed CVD, 134 had stroke, 1,382 developed liver fibrosis, and 548 died, with a median observation period of 100 months (IQR, 59-145 months). The TyG index was divided into four quartiles (Q1, Q2, Q3, Q4) and significant trends in various clinical indicators across the quartiles were observed (demographic characteristics, metabolic and biochemical indicators). Further analysis revealed linear correlations between TyG, TyG-WC, TyG-BMI, TyG-WHtR and liver function metrics (ALT, AST, GGT, FIB-4, APRI), kidney function metrics (creatinine, eGFR, uric acid), and blood lipids (triglycerides, cholesterol) (<i>P</i> < 0.01). Univariate logistic regression showed that compared to Q1, Q4 showed a significantly higher risk of liver fibrosis, CVD, stroke, and death for all TyG-related parameters (<i>P</i> < 0.001). After adjusting for cofounders, TyG Q4 still had a significantly higher risk of liver fibrosis (<i>P</i> < 0.05) and mortality (<i>P</i> < 0.001); TyG-BMI Q4 showed a higher risk of mortality (<i>P</i> < 0.001); TyG-WC Q4 showed a significantly higher risk of liver fibrosis (<i>P</i> < 0.001), stroke (<i>P</i> < 0.01), CVD (<i>P</i> < 0.001), and mortality (<i>P</i> < 0.001); TyG-WHtR Q4 showed a significantly higher risk of liver fibrosis (<i>P</i> < 0.001), stroke (<i>P</i> < 0.01), CVD (<i>P</i> < 0.001), and mortality (<i>P</i> < 0.001). Subgroup analysis yielded similar conclusions. Additionally. Survival analysis revealed significant differences in survival across the different quartiles of TyG, TyG-WC, TyG-BMI, and TyG-WHtR (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The study identified a link between TyG-related markers and negative outcomes in individuals with a normal BMI, indicating that insulin resistance exists even in non-obese populations.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1570239"},"PeriodicalIF":2.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982157","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":"Impact of preprocedural anticoagulation on the incidence of silent cerebral embolisms after catheter ablation of atrial fibrillation in patients with low thromboembolic risk.","authors":"Meng Wang, Wei Du, Ya-Lan Fei, Hao Yang, Qing-Shan Dong, Xian-Jin Li, Shi-Jie Li, Ru-Xing Wang, Bing Han","doi":"10.3389/fcvm.2025.1559347","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1559347","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate the impact of preprocedural anticoagulation on the incidence of silent cerebral embolisms (SCEs) assessed by magnetic resonance imaging (MRI) after catheter ablation of atrial fibrillation (AF) in patients with low thromboembolic risk.</p><p><strong>Methods and results: </strong>A total of 141 patients with AF who were identified with low thromboembolic risk based on CHA₂DS₂-VASc score (0 or 1 for males and 1 or 2 for females) were enrolled in this study. According to whether or not oral anticoagulants (OACs) had been administered for more than 3 weeks prior to the procedure, patients were divided into the anticoagulation group (<i>n</i> = 49) and the non-anticoagulation group (<i>n</i> = 92). Pulmonary veins were isolated by utilizing irrigated-tip ablation catheters under the guidance of the Carto system. A cerebral MRI was performed 24 to 48 h after ablation to detect any new-onset SCEs. The incidences of SCEs were compared between the two groups. SCEs were detected in 25 (17.7%) patients. The incidence of SCEs was significantly higher in the non-anticoagulation group compared with the anticoagulation group [22/92 [23.9%] vs. 3/49 [6.1%], <i>P</i> = 0.002]. Multivariate logistic regression analysis showed that the preprocedural application of OACs for more than 3 weeks was the only independent protective factor of SCEs after AF ablation.</p><p><strong>Conclusion: </strong>AF ablation carried a substantial risk of SCEs even in patients with low thromboembolic risk. Preprocedural anticoagulation for more than 3 weeks can significantly reduce the incidence of SCEs after ablation in AF patients.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1559347"},"PeriodicalIF":2.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983671","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}