Frontiers in Cardiovascular Medicine最新文献

{"title":"Comprehensive analysis of aging-related genes and immune infiltration landscape in ischemic cardiomyopathy.","authors":"Zhichao Wu, Liang Du, Xunfu Zhang, Chengyu Jin, Jinshan Ma","doi":"10.3389/fcvm.2025.1653314","DOIUrl":"10.3389/fcvm.2025.1653314","url":null,"abstract":"<p><strong>Background: </strong>Ischemic cardiomyopathy (ICM), which arises from obstructive coronary artery diseases, is a leading cause of heart failure. Aging is a major risk factor for cardiovascular diseases, yet its connection to ICM remains unclear. This study aimed to investigate the role of aging-related gene expression in the context of ICM.</p><p><strong>Methods: </strong>Human microarray data (GSE116250) were retrieved from the GEO database and aging-related differentially expressed genes (ARDEGs) were identified using the Aging Atlas database. Functional enrichment and protein-protein interaction (PPI) network analyses were performed to elucidate the functions and interactions of these ARDEGs, leading to the identification of hub genes. The immune infiltration landscape in ICM was further characterized. Subsequently, integrated regulatory networks involving the hub genes were constructed through microRNA-mRNA-transcription factor interaction and GeneMANIA analyses, while their biological functions were inferred via gene set enrichment analysis (GSEA). The predictive value of the hub genes was validated using receiver operating characteristic (ROC) analysis based on both the identification dataset (GSE116250) and an independent validation cohort (GSE1145) Finally,the expression patterns of these genes were verified by RT-qPCR on mouse disease model.</p><p><strong>Results: </strong>A total of 50 ARDEGs (42 upregulated and 8 downregulated) were identified,which are primarily involved in the response to inflammation. Ten types of immune cells showed significant alterations in the ICM heart tissues. Among these cells, CD56dim NK cells exhibited extensive and significant correlations with other immune cells. JUN was identified as a key transcription factor regulating the top five hub ARDEGs: TNF, PTGS2, IL6, IL1B, and CXCL8. ROC analysis demonstrated that TNF, CXCL8, and IL6 serve as potential biomarkers for ICM, and the combination of the three markers further improved the predictive value. RT-qPCR analysis subsequently confirmed the upregulation of these hub inflammatory ARDEGs in mouse heart tissues.</p><p><strong>Conclusion: </strong>Aging-related genes play a significant role in ICM and targeting these genes may pave the way for ICM diagnostic and therapeutic strategies.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1653314"},"PeriodicalIF":2.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185052","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":"Monocyte-lymphocyte ratio as a predictor of 3-month mortality in elderly heart failure patients: a retrospective Chinese cohort study.","authors":"Xiao-Shan Guo, Chong-Xu Wang, Hong-Ju Jiang, Jing Zhu, Jian Wang","doi":"10.3389/fcvm.2025.1665183","DOIUrl":"10.3389/fcvm.2025.1665183","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) represents the terminal phase of cardiovascular disease and is the primary cause of mortality in elderly patients diagnosed with HF. Precise early prediction of HF onset and progression is crucial for enhancing survival rates in patients. Central to HF's pathophysiology is inflammation, with the monocyte-lymphocyte ratio (MLR) emerging as a potential novel inflammatory marker. The relationship between MLR and HF in the elderly is not well-defined. Therefore, this study, utilizing the 2016-2019 Sichuan Zigong Heart Failure Database, aimed to explore the correlation between MLR levels and 3-month mortality in elderly HF patients within the Chinese population.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using the 2016-2019 Heart Failure Database from Zigong City, Sichuan Province, China. HF was identified based on the diagnostic criteria of the European Society of Cardiology. The MLR was calculated as monocyte count divided by lymphocyte count. Both lymphocyte and monocyte counts were sourced directly from laboratory datasets. Cox regression analysis was performed to assess the relationship between MLR and 3-month mortality, with stratified evaluations conducted based on age, gender, and comorbidity index.</p><p><strong>Results: </strong>Of the 1,448 elderly HF patients assessed, multivariate regression analyses revealed that the high-level MLR group had a heightened occurrence of 3-month mortalities, presenting a hazard ratio (HR) and a 95% CI of 3.31 (1.42-7.7). In the subgroup analyses, the effect sizes of MLR remained consistent across all subgroups (all <i>P-</i>values > 0.05).</p><p><strong>Conclusion: </strong>MLR is significantly associated with 3-month mortality rates in elderly HF patients. Early MLR evaluations might offer a pathway to augment the life quality and survival outcomes of these patients.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1665183"},"PeriodicalIF":2.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185053","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":"Psychometric evaluation of the cardiac rehabilitation adherence scale in patients with coronary heart disease: an observational study.","authors":"Zhenshuai Yao, Xiaohui Wen, Juping Yu, Xiaofang Zhu, Jin Wang, Pingping He, Xinping Ouyang","doi":"10.3389/fcvm.2025.1641392","DOIUrl":"10.3389/fcvm.2025.1641392","url":null,"abstract":"<p><strong>Background: </strong>Cardiac rehabilitation has showed the potential to improve health outcomes of patients with coronary heart disease. However, the adherence of patients participating in cardiac rehabilitation is unsatisfactory due to some barriers. The quantitative instrument for measuring cardiac rehabilitation adherence is scarce. Hence, the purpose of this study was to develop a scientific tool and assess its psychometric properties in patients with coronary heart disease.</p><p><strong>Material and methods: </strong>The psychometric properties of the revised scale were tested with 509 patients. Item analysis was conducted to evaluate the discrimination and homogeneity of the scale. Content validity was evaluated by content validity index and Exploratory factor analyses and confirmatory factor analyses were used to examine the factor structure of the scale. Reliability was evaluated by Cronbach's coefficients and split-half reliability coefficients.</p><p><strong>Results: </strong>A scale covering five dimensions and thirty-three items was developed for evaluating cardiac rehabilitation adherence. The content validity index of the scale was 0.96. In exploratory factor analysis, a five-factor structure model was confirmed, explaining 71.255% of the total variation. In confirmatory factor analysis, the five- factor structure was supported by appropriate fitting indexes. In terms of reliability, the Cronbach's <i>α</i> coefficient of the scale was 0.909 and the spilt-half reliability coefficient of the scale was 0.765.</p><p><strong>Conclusion: </strong>The newly developed self-completion scale is reliable and valid. It appears to be a sound instrument for nurses and a broader range of healthcare professionals to effectively evaluate the cardiac rehabilitation adherence.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1641392"},"PeriodicalIF":2.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185095","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":"TyG index and CBC-derived inflammatory indicators individual and mixed effects on all-cause and cardiovascular disease deaths in patients with CHD.","authors":"Lipeng Cai, Jiangrong Yan, Lei Sun, Weichao Dan","doi":"10.3389/fcvm.2025.1600097","DOIUrl":"10.3389/fcvm.2025.1600097","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aims: &lt;/strong&gt;Currently, most epidemiological investigations have concentrated on exploring the correlation between a singular indicator and the risk of cardiovascular disease. In clinical practice, a single indicator often fails to comprehensively represent a patient's health status. Consequently, it is crucial to thoroughly evaluate the influence of multiple indicators on disease prediction. Recently, the Triglyceride-Glucose Index (TyG Index) and inflammatory markers derived from CBC (CBC) have garnered increasing attention. Nevertheless, research on the individual and synergistic impacts of the TyG index and inflammatory indices on the risk of all-cause mortality and cardiovascular death in patients with coronary heart disease (CHD) remains scarce. To develop a more accurate risk assessment instrument for the clinic and to provide a novel strategy and framework for the management of individuals with coronary artery disease (CAD).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods and results: &lt;/strong&gt;This study identified patients with CHD aged 20 years and older from five cycles of National Health and Nutrition Examination Survey (NHANES) data spanning 2009 to 2018. We employed weighted logistic regression analysis and the restricted cubic spline (RCS) approach to investigate the TyG index and CBC-derived inflammatory indicators in relation to the risk of all-cause mortality and cardiovascular mortality in patients with CHD. The cumulative exposure effect of these measures was estimated utilizing a Weighted Quantitative Scoring (WQS) model. In the unadjusted model, ln(SII) (OR = 1.8, 95% CI = 1.05 ∼ 3.06, &lt;i&gt;P&lt;/i&gt; = 0.032), ln(SIRI) (OR = 2.08, 95% CI = 1.45 ∼ 2.98, &lt;i&gt;P&lt;/i&gt; &lt; 0.001), ln(MLR) (OR = 2.53, 95% CI = 1.55 ∼ 4.13, &lt;i&gt;P&lt;/i&gt; &lt; 0.001), ln(NLR) (OR = 2.57, 95% CI = 1.44 ∼ 4.60, &lt;i&gt;P&lt;/i&gt; = 0.002), and ln(PLR) (OR = 2.56, 95% CI = 1.53 ∼ 4.29, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) exhibited a positive correlation with the risk of all-cause mortality. In the model, after comprehensive adjustment for confounders, it continued to exhibit a substantial association with the risk of mortality from CHD. RCS analysis revealed a nonlinear dose-response relationship between Monocyte-to-Lymphocyte Ratio (MLR), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Systemic Immune-Inflammation Index (SII), and Systemic Inflammation Response Index (SIRI) and the probability of all-cause mortality (&lt;i&gt;P&lt;/i&gt; -nonlinear &lt; 0.05). The WQS model indicated that simultaneous exposure to the TyG index and inflammatory markers derived from CBC was significantly and positively associated with the risk of all-cause mortality and cardiovascular death in patients with CAD (OR = 1.68, 95% CI = 1.22-2.30, &lt;i&gt;P&lt;/i&gt; = 0.009, and OR = 2.2, 95% CI = 1.42-3.42, &lt;i&gt;P&lt;/i&gt; = 0.0004), with the Neutrophil-to-Platelet Ratio (NPR) and SII being the most significant contributors to the overall risk.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our investigation demonstrated that the TyG i","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1600097"},"PeriodicalIF":2.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148590","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 dynamic evolution of the de Winter ECG pattern that is easily overlooked and life-threatening: a case report and literature review.","authors":"Yingmei Chen, Bao Chen, Lili Zhang, Wang Liao, Miao Wang","doi":"10.3389/fcvm.2025.1574829","DOIUrl":"10.3389/fcvm.2025.1574829","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Rapid diagnosis of patients with acute coronary syndrome (ACS) is crucial for saving their lives. The de Winter electrocardiogram (ECG) pattern is rare and is treated similarly to ST-segment elevation myocardial infarction (STEMI) and acute thrombotic occlusion of the coronary artery. The de Winter ECG pattern has been previously reported, but its dynamic evolution and characteristics have not been summarized.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We reported two male patients who presented with de Winter ECG pattern at rest, and neither patient had a family history of hypertension, diabetes, or coronary heart disease. An urgent examination in our hospital showed elevated levels of cardiac troponin T. Both patients underwent emergency coronary angiography, which revealed subtotal proximal left anterior descending (LAD) stenosis. There was an improvement in chest tightness and pain after stent implantation. Serial ECGs before and after percutaneous coronary intervention showed dynamic evolution of ECG. A literature review was conducted to examine reported coronary angiography findings in patients with the de Winter pattern. The review focused on the dynamic evolution of the ECG and the accuracy of this pattern in diagnosing acute coronary artery occlusion (culprit vessel). It also highlighted the danger of the de Winter ECG pattern and the importance of emergency treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Eighteen patients, including two of our patients, presented with the de Winter ECG pattern. Our two cases demonstrated two different forms of ST-segment dynamic evolution, with Case 2 being the only one among 18 cases that dynamically evolved into a life-threatening non-STEMI (NSTEMI). All cases were male patients with sudden chest pain. ECG examination showed an upward-sloping ST-segment depression with tall symmetrical T waves in the chest leads, and multiple follow-up ECGs revealed dynamic ST-segment evolution. Emergency coronary angiography showed occlusion of the LAD, left main artery (LMA), right coronary artery (RCA), first diagonal branch (D1), and left circumflex (LCX) artery as well as multiple vascular lesions. Most cases support subtotal stenosis or complete occlusion of the anterior descending artery. Timely identification of the de Winter ECG pattern and prompt transfer to the catheterization laboratory for emergency revascularization can be lifesaving and improve prognosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;These two cases and the literature review indicated that the de Winter ECG pattern is dynamically evolving. Its ECG pattern evolution is variable, progressing to STEMI, NSTEMI, Wellens, or even a normal. In patients presenting with chest pain, a de Winter ECG pattern, regardless of the subsequent dynamic evolution of the ECG, indicates the presence of severe coronary artery stenosis. The de Winter ECG pattern may be an early manifestation of ACS and requires urgent coronary angiography to save the pati","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1574829"},"PeriodicalIF":2.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148564","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":"Extracorporeal membrane oxygenation-supported one-stop surgery for transcatheter aortic valve replacement and percutaneous coronary intervention in high-risk complex coronary artery and aortic valvular disease: a case report.","authors":"Zhihan Zhang, Dongsheng Wang, Yanan Yu, Beibei Du, Zhongfan Zhang, Guohui Liu","doi":"10.3389/fcvm.2025.1604387","DOIUrl":"10.3389/fcvm.2025.1604387","url":null,"abstract":"<p><p>Aortic stenosis (AS) is frequently associated with coronary artery disease (CAD), particularly in high-risk patients for whom treatment strategies lack standardized clinical guidelines. We report a case of a patient with severe AS and high-risk CAD, leading to significant heart failure, for whom surgical aortic valve replacement and coronary artery bypass grafting were unsuitable because of very high risk of morbidity and mortality. The patient underwent a one-stop procedure combining extracorporeal membrane oxygenation (ECMO)-assisted transcatheter aortic valve replacement (TAVR) and percutaneous coronary intervention (PCI). During the procedure, the patient first received preventive veno-arterial ECMO placement, successfully underwent PCI on the right coronary artery and left anterior descending artery, and then TAVR was performed without complications. The patient tolerated the procedure well, with hemodynamics remaining stable throughout. At one-year follow-up, the patient's heart function was significantly improved. This case provides valuable experience in treating high-risk AS combined with CAD, demonstrating the feasibility and effectiveness of this approach in clinical practice.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1604387"},"PeriodicalIF":2.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148574","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":"Role of peri-deployment right ventricular paced-ECG in left bundle area pacing.","authors":"Wen-De Tang, Chiung-Ray Lu, Mei-Yao Wu, Ching-Fen Chang, Wei-Hsin Chung, Yin-Huei Chen, Hung-Pin Wu, Hei-Tung Yip, Kuan-Cheng Chang, Yen-Nien Lin","doi":"10.3389/fcvm.2025.1555683","DOIUrl":"10.3389/fcvm.2025.1555683","url":null,"abstract":"<p><strong>Background: </strong>Left bundle area pacing (LBBAP) has emerged as a promising physiological pacing modality. The current technique for LBBAP lead implantation predominantly relies on the anatomy of the His bundle and right ventricular septum. While practical, this anatomical approach can lead to variations in lead polarity and QRS durations due to the relatively extensive target zone.</p><p><strong>Objectives: </strong>This study aims to investigate whether peri-deployment paced ECGs can effectively guide LBBAP and enhance left ventricular activation.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 41 patients (54 attempts) who underwent LBBAP between 1 September 2020 and 30 June 2021. We collected and analyzed demographic data, baseline ECGs, intraprocedural ECGs, and ventricular local electrograms. QRS patterns were categorized into five common types, R, Rs, rs, rS, and S, and were labeled from 1 to 5 for polarity analysis. In addition, we explored markers associated with achieving shorter QRS durations (<120 ms).</p><p><strong>Results: </strong>LBBAP was successfully achieved in 81.5% of the attempts. During the procedure, the paced QRS duration (QRSd) significantly decreased from 144.5 ± 22.6 ms-128.8 ± 22.9 ms (<i>p</i> < 0.001). Comparing lead polarity scores before and after deployment revealed a significant increase in leads I and aVL (lead I, 1.3 ± 0.9 vs. 1.6 ± 1.0, <i>p</i> = 0.002; lead aVL, 1.6 ± 1.0 vs. 2.1 ± 1.3, <i>p</i> = 0.002), while leads III and aVF showed a decrease (lead III, 3.9 ± 1.2 vs. 3.4 ± 1.5, <i>p</i> = 0.001; lead aVF, 3.1 ± 1.2 vs. 2.9 ± 1.3, <i>p</i> = 0.026). The polarity of leads II and aVR remained unchanged. In the subgroup with post-deployment QRSd shorter than 120 ms, although the Qr pattern in lead V1 was only numerically higher (95.2% vs. 81.8%, <i>p</i> = 0.310), the lead polarity scores were significantly higher in leads I and aVL and lower in leads III and aVF (<i>p</i> < 0.001). This group also had a significantly shorter left ventricular activation time (LVAT) (68.7 ± 13.0 ms vs. 98.4 ± 14.0 ms, <i>p</i> < 0.001). Univariate analysis revealed that a shorter pre-deployment paced QRSd and LVAT were associated with a narrower post-deployment QRSd. In addition, non-electrical factors such as female gender and left ventricular dilation were associated with higher post-deployment QRSd.</p><p><strong>Conclusions: </strong>Peri-deployment ECG assessment is a practical adjunct to anatomy-based LBBAP, providing real-time markers for optimal lead positioning. Specifically, an unaltered lead II axis and expected changes in the lead I/aVL and lead III/aVF axes can help guide the selection of the left bundle branch. Lower pre-deployment paced QRSd and LVAT, as well as a more rightward inferior axis after deployment, are associated with a shorter post-deployment QRSd.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1555683"},"PeriodicalIF":2.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148535","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":"\"Intracoronary levosimendan in neonatal cardiac surgery: a retrospective study on hemodynamic effects and catecholamine-sparing outcomes\".","authors":"Talgat Ibraev, Gulmira Zhauarova, Amangeldi Kerimkulov, Kamilla Rakhimova, Erlic Sungkarbekov","doi":"10.3389/fcvm.2025.1577847","DOIUrl":"10.3389/fcvm.2025.1577847","url":null,"abstract":"<p><strong>Background: </strong>Levosimendan is a calcium-sensitizing inotrope with vasodilatory properties, shown to improve cardiac output and reduce mortality in adults with advanced heart failure. However, data on its safety and efficacy in neonatal cardiac surgery are limited.</p><p><strong>Objective: </strong>To evaluate the intraoperative use of levosimendan in neonates with complex congenital heart defects (CHDs) undergoing open-heart surgery.</p><p><strong>Methods: </strong>We conducted a retrospective observational study of 59 neonates aged 2-30 days who underwent surgical correction of complex CHDs with cardiopulmonary bypass. Levosimendan was administered intracoronarily as part of the blood cardioplegia protocol in doses of 25-45 mcg/kg.</p><p><strong>Results: </strong>Compared to historical controls, the levosimendan group demonstrated a significant reduction in postoperative catecholamine requirements, including adrenaline and norepinephrine. In 12% of cases, surgery was completed without the use of any catecholamines. No rhythm disturbances were observed. The positive inotropic effect lasted up to 72 h without systemic hypotension. Median adrenaline doses were significantly lower (p < 0.05), and norepinephrine use was reduced from 12% to 5%.</p><p><strong>Conclusions: </strong>Intracoronary administration of levosimendan during neonatal cardiac surgery appears to reduce catecholamine dependence and support myocardial recovery without causing rhythm disturbances or hypotension. Further randomized controlled trials are needed to validate these findings.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1577847"},"PeriodicalIF":2.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148588","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 to predict the risk of type II endoleak after endovascular aneurysm repair.","authors":"Bowen Liu, Xiaobin Tang, Nan He, Zhong Chen","doi":"10.3389/fcvm.2025.1639697","DOIUrl":"10.3389/fcvm.2025.1639697","url":null,"abstract":"<p><strong>Objective: </strong>Type II endoleak (T2EL) is the most common complication following endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAA). T2EL may lead to aneurysm sac expansion and rupture. Identifying high-risk patients is crucial for prophylaxis and early intervention.</p><p><strong>Methods: </strong>This single-center retrospective study included 332 patients who underwent EVAR for infrarenal AAA. Demographic, clinical, anatomical, and medication-related data were collected. A nomogram was developed based on significant predictors. Its performance was assessed by receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA).</p><p><strong>Results: </strong>T2EL occurred in 70 (21.08%) of 332 patients. Multivariate logistic regression revealed six independent predictors: age, smoking status, intraluminal thrombus (ILT), number of patent lumbar arteries (LA), inferior mesenteric artery (IMA) diameter, and IMA patency. The nomogram demonstrated excellent calibration and strong predictive ability, with an area under the curve (AUC) of 0.806 (training set) and 0.758 (validation set). DCA showed clinical benefit across threshold probabilities of 1%-66% and 79%-92% in the training set, and 1%-84% in the validation set.</p><p><strong>Conclusion: </strong>The proposed nomogram effectively integrates clinical and anatomical factors to assess the risk of T2EL after EVAR. It may help identify patients requiring intensified surveillance or early interventions to mitigate complications. Further multicenter, prospective studies are needed to validate the nomogram's applicability.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1639697"},"PeriodicalIF":2.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148545","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":"Case Report: Transient hypertension and myalgia following mavacamten therapy in a patient with hypertrophic obstructive cardiomyopathy.","authors":"Mengling Peng, Yu Fu, Cong Qin, Shanshan Zhou, Jian Sun","doi":"10.3389/fcvm.2025.1578356","DOIUrl":"10.3389/fcvm.2025.1578356","url":null,"abstract":"<p><strong>Background: </strong>Mavacamten has been demonstrated to be effective in the treatment of hypertrophic obstructive cardiomyopathy (HOCM). However, its hemodynamic impact and extracardiac effects require further characterization.</p><p><strong>Case presentation: </strong>We report a case of a 68-year-old female diagnosed with severe HOCM who experienced transient hypertension (165/105 mmHg) and myalgia four weeks after mavacamten initiation. Despite a significant reduction in LVOT obstruction (from 64 mmHg-18 mmHg) and an increase in LVEF to 78%, the patient exhibited a transient hypertensive response that resolved spontaneously within two weeks without intervention. Myalgia was present without corresponding elevations in serum creatine kinase.</p><p><strong>Conclusions: </strong>This case highlights a previously unrecognized transient hypertensive phase associated with myosin inhibition, potentially related to ventriculo-arterial decoupling and peripheral vascular adaptation. Additionally, the dissociation between myalgia and CK elevation suggests alternative skeletal muscle involvement mechanisms. Close blood pressure monitoring and further investigation into the extracardiac effects of mavacamten are warranted.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1578356"},"PeriodicalIF":2.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148606","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}