Heart and Vessels最新文献

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Prognostic impact of pre-procedural blood pressure profiles on clinical outcomes in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. 经皮冠状动脉介入治疗st段抬高型心肌梗死患者术前血压对临床预后的影响
IF 1.5 4区 医学
Heart and Vessels Pub Date : 2026-07-01 Epub Date: 2025-12-29 DOI: 10.1007/s00380-025-02642-3
Viroj Muangsillapasart, Eiji Shibahashi, Takanori Kawamoto, Hisao Otsuki, Hiroyuki Arashi, Kazuho Kamishima, Kentaro Jujo, Toshiaki Oka, Fumiaki Mori, Hiroyuki Tanaka, Tomohiro Sakamoto, Yasuhiro Ishii, Yutaka Terajima, Masahiro Yagi, Atsushi Takagi, Shoji Haruta, Junichi Yamaguchi
{"title":"Prognostic impact of pre-procedural blood pressure profiles on clinical outcomes in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention.","authors":"Viroj Muangsillapasart, Eiji Shibahashi, Takanori Kawamoto, Hisao Otsuki, Hiroyuki Arashi, Kazuho Kamishima, Kentaro Jujo, Toshiaki Oka, Fumiaki Mori, Hiroyuki Tanaka, Tomohiro Sakamoto, Yasuhiro Ishii, Yutaka Terajima, Masahiro Yagi, Atsushi Takagi, Shoji Haruta, Junichi Yamaguchi","doi":"10.1007/s00380-025-02642-3","DOIUrl":"10.1007/s00380-025-02642-3","url":null,"abstract":"<p><p>Elevated systolic blood pressure (SBP) increases myocardial oxygen demand, whereas low diastolic blood pressure (DBP) can impair coronary perfusion. The prognostic impact of this high-SBP/low-DBP (HSLD) profile in patients with ST-elevation myocardial infarction (STEMI) remains unknown. We analyzed 696 consecutive patients with STEMI undergoing primary percutaneous coronary intervention (PCI) from a prospective 11-center registry in Japan. Patients were categorized based on pre-procedural SBP (≥ 120 mmHg) and DBP (< 70 mmHg) into four groups: high-SBP/low-DBP (HSLD) high-SBP/high-DBP (HSHD), low-SBP/high-DBP (LSHD), and low-SBP/low-DBP (LSLD). The primary endpoint was a 1-year composite of cardiovascular death, non-fatal myocardial infarction, or stroke. Median follow-up was 369 days. The 1-year cumulative incidence of the primary endpoint was 7 (9.5%) in the HSLD group, 19 (4.2%) in the HSHD group, 2 (2.8%) in the LSHD group, and 5 (6.0%) in the LSLD group (log-rank p = 0.007). In multivariable Cox regression, the HSLD was independently associated with the primary endpoint compared to the HSHD group (hazard ratio 3.20, 95% CI 1.04-9.87; p = 0.043). The prognostic value of HSLD was consistent across major subgroups. A pre-procedural blood pressure pattern of SBP ≥ 120 mmHg combined with DBP < 70 mmHg independently predicts a higher risk of adverse cardiovascular events at 1 year in patients with STEMI. This simple measurement at admission identifies a previously unrecognized high-risk phenotype and presents a valuable opportunity for early risk stratification.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"443-450"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145855579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of aerobic exercise habits with higher albumin-globulin ratio and lower cellular immune-inflammatory markers: implication of the preventive effect of aerobic exercise on atherosclerotic cardiovascular disease. 有氧运动习惯与较高的白蛋白-球蛋白比率和较低的细胞免疫-炎症标志物的关联:有氧运动对动脉粥样硬化性心血管疾病的预防作用的含义
IF 1.5 4区 医学
Heart and Vessels Pub Date : 2026-07-01 Epub Date: 2025-07-19 DOI: 10.1007/s00380-025-02585-9
Leiying Zhang
{"title":"Association of aerobic exercise habits with higher albumin-globulin ratio and lower cellular immune-inflammatory markers: implication of the preventive effect of aerobic exercise on atherosclerotic cardiovascular disease.","authors":"Leiying Zhang","doi":"10.1007/s00380-025-02585-9","DOIUrl":"10.1007/s00380-025-02585-9","url":null,"abstract":"<p><p>This correspondence identifies irreconcilable contradictions in Tani et al.'s article (Heart Vessels. 2025;40:509-522) that critically undermine its conclusions. Key concerns include paradoxical relationships between smoking and albumin-globulin ratio (AGR), discordant liver enzyme patterns, and inconsistent inflammatory marker responses. Alternative mechanisms involving humoral suppression and hepatic adaptation better explain the findings. The study's cross-sectional design cannot resolve these discrepancies, necessitating longitudinal validation before clinical interpretation.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"504-505"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Response: Association of aerobic exercise habits with higher albumin-globulin ratio and lower cellular immune-inflammatory markers: implication of the preventive effect of aerobic exercise on atherosclerotic cardiovascular disease. 响应:有氧运动习惯与较高的白蛋白-球蛋白比率和较低的细胞免疫-炎症标志物的关联:有氧运动对动脉粥样硬化性心血管疾病的预防作用的含义。
IF 1.5 4区 医学
Heart and Vessels Pub Date : 2026-07-01 Epub Date: 2025-07-31 DOI: 10.1007/s00380-025-02586-8
Shigemasa Tani, Kazuhiro Imatake, Yasuyuki Suzuki, Tsukasa Yagi, Atsuhiko Takahashi
{"title":"Response: Association of aerobic exercise habits with higher albumin-globulin ratio and lower cellular immune-inflammatory markers: implication of the preventive effect of aerobic exercise on atherosclerotic cardiovascular disease.","authors":"Shigemasa Tani, Kazuhiro Imatake, Yasuyuki Suzuki, Tsukasa Yagi, Atsuhiko Takahashi","doi":"10.1007/s00380-025-02586-8","DOIUrl":"10.1007/s00380-025-02586-8","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"506-507"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Estimated glucose disposal rate (eGDR) predicts rehospitalization & death in acute decompensated heart failure in the elderly. 估计葡萄糖处置率(eGDR)预测老年人急性失代偿性心力衰竭的再住院和死亡。
IF 1.5 4区 医学
Heart and Vessels Pub Date : 2026-07-01 Epub Date: 2025-12-29 DOI: 10.1007/s00380-025-02643-2
Wenliang Zhai, Mingyi He, Chunyuan Wang, Jingyu He, Tao Wang, Xiurong Xing, Zhi Liu, Shubin Guo
{"title":"Estimated glucose disposal rate (eGDR) predicts rehospitalization & death in acute decompensated heart failure in the elderly.","authors":"Wenliang Zhai, Mingyi He, Chunyuan Wang, Jingyu He, Tao Wang, Xiurong Xing, Zhi Liu, Shubin Guo","doi":"10.1007/s00380-025-02643-2","DOIUrl":"10.1007/s00380-025-02643-2","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the short-term predictive value of the estimated glucose disposal rate (eGDR) for rehospitalization or death in elderly patients with acute decompensated heart failure (ADHF).</p><p><strong>Methods: </strong>117 elderly patients with ADHF admitted to our hospital from January 2020 to January 2022 were recruited and divided into control (80 cases) and event (37 cases) groups based on whether they were rehospitalized or died within 90 days following discharge. Basic information, clinical characteristics, and laboratory test results of them were collected, and the eGDR was calculated. Multivariate logistic regression analysis identified the independent factors associated with the short-term prognosis, and receiver operating characteristic (ROC) curves assessed the predictive value of eGDR.</p><p><strong>Results: </strong>The event group had significantly higher rates of comorbid diabetes (DM), hypertension, Class IV heart failure, and cardiogenic shock, as well as a larger waist circumference, higher peak troponin I during hospitalization, greater glycated hemoglobin (HbA1c) and fasting blood glucose (FBG), and lower eGDR values compared to the control group (P < 0.05). Multivariate logistic regression showed that comorbid hypertension, DM, Class IV cardiac function, cardiogenic shock, FBG, HbA1c, and eGDR were independent factors associated with poor short-term prognosis in elderly patients with ADHF (P < 0.05). ROC curve analysis showed that the area under the curve for eGDR in predicting poor short-term prognosis was 0.84 (P = 0.04), with an optimal cutoff value of 5.31, a sensitivity of 83.8%, and a specificity of 70.1%. Patients with eGDR < 5.31 had a significantly higher incidence of rehospitalization or death within 90 days compared to those with higher eGDR (52.0% vs. 16.5%, P < 0.001).</p><p><strong>Conclusion: </strong>eGDR is an independent predictor of poor short-term prognosis in elderly patients with ADHF: a low eGDR was associated with a higher risk of rehospitalization and death within 90 days.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"461-471"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145855605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
HELT-E2S2 score in ischemic stroke: a step forward in risk prediction, but gaps remain. 缺血性脑卒中的HELT-E2S2评分:在风险预测方面向前迈进了一步,但差距仍然存在。
IF 1.5 4区 医学
Heart and Vessels Pub Date : 2026-07-01 Epub Date: 2025-07-23 DOI: 10.1007/s00380-025-02590-y
Brijesh Sathian, Javed Iqbal, Syed Muhammad Ali, Ayesha Parvaiz Malik
{"title":"HELT-E2S2 score in ischemic stroke: a step forward in risk prediction, but gaps remain.","authors":"Brijesh Sathian, Javed Iqbal, Syed Muhammad Ali, Ayesha Parvaiz Malik","doi":"10.1007/s00380-025-02590-y","DOIUrl":"10.1007/s00380-025-02590-y","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"508-509"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Divergent effects of exercise training on peak oxygen uptake and 6-min walk distance in older HFpEF patients with and without type 2 diabetes mellitus. 运动训练对伴有和不伴有2型糖尿病的老年HFpEF患者的峰值摄氧量和6分钟步行距离的不同影响
IF 1.5 4区 医学
Heart and Vessels Pub Date : 2026-07-01 Epub Date: 2025-12-29 DOI: 10.1007/s00380-025-02645-0
Yousuke Sugita, Ayano Kudo, Sota Arakawa, Satoshi Sakai
{"title":"Divergent effects of exercise training on peak oxygen uptake and 6-min walk distance in older HFpEF patients with and without type 2 diabetes mellitus.","authors":"Yousuke Sugita, Ayano Kudo, Sota Arakawa, Satoshi Sakai","doi":"10.1007/s00380-025-02645-0","DOIUrl":"10.1007/s00380-025-02645-0","url":null,"abstract":"<p><p>Reduced exercise capacity is a hallmark of heart failure with preserved ejection fraction (HFpEF), and this limitation is particularly pronounced in older patients with coexisting type 2 diabetes mellitus (T2DM), a high-risk population characterized by poor prognosis. Although previous studies have demonstrated that exercise training (ET) can improve exercise capacity in patients with HFpEF, its efficacy in older patients with coexisting HFpEF and T2DM remains unclear. Therefore, we evaluated the effects of ET on peak oxygen uptake (peakVO<sub>2</sub>) and 6-min walk distance (6MWD) in older patients with HFpEF and investigated whether these effects differ based on T2DM status. A total of 99 stable outpatients with HFpEF aged 65 to 80 years were enrolled. Participants were classified into four groups based on T2DM and ET status: T2DM-ET (n = 25), non-T2DM-ET (n = 24), T2DM-usual-care (UC; n = 26), and non-T2DM-UC (n = 24). PeakVO<sub>2</sub> and hemodynamic responses during exercise were assessed using cardiopulmonary exercise testing and impedance cardiography. Additionally, walking distance, cadence, step length, and metabolic cost were assessed during the 6-min walk test. The interaction between T2DM and ET on changes in these parameters was analyzed using multivariable-adjusted linear regression. ET significantly improved peakVO<sub>2</sub> after 5 months; however, the magnitude of improvement was attenuated in the T2DM group (0.5 mL/kg/min) compared with that in the non-T2DM group (1.9 mL/kg/min; p < 0.001). This difference was primarily attributable to a blunted increase in arteriovenous oxygen difference, which increased by only 0.2 mL/100 mL in the T2DM group vs. 0.4 mL/100 mL in the non-T2DM group (p < 0.001). In contrast, improvements in 6MWD were similar between the groups (29 vs. 31 m; p = 0.651). Step length remained unchanged, whereas cadence increased in the T2DM and non-T2DM groups (11 vs. 8 steps/min, respectively), accompanied by a reduction in metabolic cost (- 0.06 vs. - 0.04 mL/kg/m), indicating enhanced walking efficiency regardless of T2DM status. Although T2DM attenuated improvements in peakVO<sub>2</sub>, the walking efficiency and functional capacity improved with ET regardless of T2DM status. These findings highlight the potential value of ET in older patients with HFpEF, irrespective of T2DM status. This trial was registered with the University Hospital Medical Information Network, Japan (registration number: UMIN000045474; registration date: September 13th, 2021).</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"472-485"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145855546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Global longitudinal strain decline after anthracyclines in a relatively low-risk Japanese breast cancer cohort. 在一个相对低风险的日本乳腺癌队列中,蒽环类药物后全球纵向菌株下降。
IF 1.5 4区 医学
Heart and Vessels Pub Date : 2026-07-01 Epub Date: 2025-12-29 DOI: 10.1007/s00380-025-02644-1
Kyohei Daigo, Yasuyuki Shiraishi, Seien Ko, Yoshinori Katsumata, Tetsu Hayashida, Takahiro Hiraide, Hiroki Kitakata, Hikaru Tsuruta, Takamichi Yokoe, Aiko Nagayama, Tomoko Seki, Maiko Takahashi, Yuko Kitagawa, Yuji Itabashi, Masaki Ieda, Masaharu Kataoka
{"title":"Global longitudinal strain decline after anthracyclines in a relatively low-risk Japanese breast cancer cohort.","authors":"Kyohei Daigo, Yasuyuki Shiraishi, Seien Ko, Yoshinori Katsumata, Tetsu Hayashida, Takahiro Hiraide, Hiroki Kitakata, Hikaru Tsuruta, Takamichi Yokoe, Aiko Nagayama, Tomoko Seki, Maiko Takahashi, Yuko Kitagawa, Yuji Itabashi, Masaki Ieda, Masaharu Kataoka","doi":"10.1007/s00380-025-02644-1","DOIUrl":"10.1007/s00380-025-02644-1","url":null,"abstract":"<p><strong>Background: </strong>Anthracyclines are known to exhibit dose-dependent cardiotoxicity, leading to cancer therapy-related cardiac dysfunction (CTRCD). The significance of routine global longitudinal strain (GLS) measurements remains uncertain in patients at low or moderate risk for cardiotoxicity. This study aimed to investigate the appropriateness of the contemporary CTRCD surveillance strategy in this population.</p><p><strong>Methods: </strong>We prospectively enrolled women with breast cancer undergoing anthracycline-based chemotherapy at Keio University Hospital from April 2018 to November 2023. Cardiotoxicity risk was assessed using the Heart Failure Association-International Cardio-Oncology Society (HFA-ICOS) tool. GLS was measured by echocardiography at baseline (T0), completion of anthracyclines (T1), and 6 months (T2) and 12 months (T3) after initiating chemotherapy. CTRCD was defined as a > 15% relative decline in GLS from baseline. Repeated GLS measurements were analyzed using linear mixed models with post-hoc Tukey testing.</p><p><strong>Results: </strong>Fifty-eight patients (mean age 53.8 ± 9.3 years) were included, with 53 (91.3%) classified as low or moderate risk. GLS significantly declined at T2 and returned toward baseline at T3. GLS-based CTRCD was observed in 4 (6.9%), 14 (24.1%), and 4 (6.9%) patients at T1, T2, and T3, respectively. The majority of CTRCD cases showed spontaneous recovery by T3. Persistent CTRCD at T3 was limited to a small number of patients and was significantly associated with higher high-sensitivity cardiac troponin T levels at T1 (area under curve = 0.836; 95% CI, 0.674-0.997), with a Youden index-derived cutoff of 0.016 ng/mL by receiver operating characteristic analysis.</p><p><strong>Conclusions: </strong>In breast cancer patients with low to moderate cardiotoxicity risk, early GLS decline following anthracycline exposure was mostly transient. These findings support current surveillance recommendations and suggest a potential role for troponin in identifying patients at risk for persistent dysfunction.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"495-503"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145855626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exercise-based cardiac rehabilitation after aortic dissection: a systematic review of exercise prescription and blood pressure-guided management. 主动脉夹层后以运动为基础的心脏康复:运动处方和血压指导管理的系统回顾。
IF 1.5 4区 医学
Heart and Vessels Pub Date : 2026-06-30 DOI: 10.1007/s00380-026-02727-7
Kiyonori Kobayashi
{"title":"Exercise-based cardiac rehabilitation after aortic dissection: a systematic review of exercise prescription and blood pressure-guided management.","authors":"Kiyonori Kobayashi","doi":"10.1007/s00380-026-02727-7","DOIUrl":"https://doi.org/10.1007/s00380-026-02727-7","url":null,"abstract":"<p><p>Survival after acute aortic dissection (AAD) has improved substantially; however, optimal exercise prescription and blood pressure (BP) thresholds during cardiac rehabilitation (CR) remain unclear. Although current guidelines recommend CR after aortic repair, evidence-based BP thresholds are undefined. A systematic search of PubMed and the Cochrane Library identified 88 records. After screening and eligibility assessment, 27 studies were included. Eligible studies investigated exercise-based rehabilitation, early mobilization, or BP-guided exercise management in patients with Stanford type A or B aortic dissection. Data on exercise intensity, BP limits, monitoring strategies, safety outcomes, and functional recovery were extracted and narratively synthesized. Most studies were observational, with only one randomized controlled trial evaluating early goal-directed mobilization. Exercise intensity was typically prescribed as low-to-moderate and frequently constrained by systolic BP thresholds; however, reported upper limits were inconsistent and often not explicitly defined or evidence-justified. Continuous or intermittent BP monitoring was commonly employed in early phases. Across studies, exercise-based cardiac rehabilitation was not clearly associated with increased rates of re-dissection or major adverse events, and early mobilization was associated with improved activities of daily living and shorter functional recovery time. Of the 27 included studies, explicit systolic blood pressure thresholds for exercise were reported in fewer than one-third, and quantitative descriptions of aortic event rates were provided in only a minority, with most studies concluding safety based on qualitative assessments; however, the absence of reported events does not necessarily indicate evidence of safety. Exercise-based cardiac rehabilitation following aortic dissection appears feasible when conducted under BP-guided monitoring, with no clear signal of increased aortic risk reported in the available literature. However, the current evidence remains largely qualitative and heterogeneous, highlighting the need for standardized exercise intensity criteria and prospective studies to establish evidence-based rehabilitation strategies.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Differential prognostic impact of interleukin-6 in acute heart failure with reduced versus preserved ejection fraction. 白细胞介素-6在急性心力衰竭伴射血分数降低与保留的预后差异影响。
IF 1.5 4区 医学
Heart and Vessels Pub Date : 2026-06-30 DOI: 10.1007/s00380-026-02723-x
Makoto Kishihara, Yuichiro Minami, Hidetoshi Hattori, Shintaro Haruki, Junichi Yamaguchi
{"title":"Differential prognostic impact of interleukin-6 in acute heart failure with reduced versus preserved ejection fraction.","authors":"Makoto Kishihara, Yuichiro Minami, Hidetoshi Hattori, Shintaro Haruki, Junichi Yamaguchi","doi":"10.1007/s00380-026-02723-x","DOIUrl":"10.1007/s00380-026-02723-x","url":null,"abstract":"<p><p>Interleukin-6 (IL-6) plays a role in acute heart failure (AHF) and can predict death and re-hospitalization. However, the relationship between IL-6 levels and mortality, based on heart failure phenotype, remains unclear. This study aimed to clarify the association between IL-6 levels and mortality in patients with AHF with reduced ejection fraction (HFrEF) and with preserved ejection fraction (HFpEF). A retrospective observational study was conducted on 371 AHF cases admitted to our institution. Patients were categorized into two groups based on IL-6 levels using Receiver Operating Characteristic (ROC) curve analysis: those with IL-6 below 29.0 pg/mL (N = 239) and those above 29.0 pg/mL (N = 132). Mortality rates were assessed for both HFrEF and HFpEF patients to determine the differential impact of IL-6. The average age was 71 years, with 60% male. Over a median follow-up of 222 days, 53 patients (14.8%) died. Kaplan-Meier analysis revealed a significantly higher mortality rate in patients with IL-6 levels above 29.0 pg/mL (P < 0.001). Elevated IL-6 levels were associated with increased mortality in both categories of left ventricular ejection fraction. In particular, among patients with HFrEF, those with elevated IL-6 levels exhibited a higher risk of death after 30 days (P = 0.017), while HFpEF patients with elevated IL-6 levels had a higher risk of death within 30 days (P = 0.002). Elevated IL-6 levels predicted higher all-cause mortality in both HFrEF and HFpEF patients. The effect of elevated IL-6 on mortality varies between short-term and long-term implications for HFrEF and HFpEF.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Combined assessment of left ventricular and atrial function for transthyretin amyloid cardiomyopathy. 转甲状腺素淀粉样心肌病左室和心房功能的联合评估。
IF 1.5 4区 医学
Heart and Vessels Pub Date : 2026-06-30 DOI: 10.1007/s00380-026-02729-5
Arisa Senda, Hidekazu Tanaka, Momo Fujiwara, Koya Uemura, Yasushi Ichikawa, Shun Nagai, Yu Nishihara, Chihiro Fujii, Hiroshi Tsunamoto, Masayuki Kintsu, Terunobu Fukuda, Eriko Hisamatsu, Hiromasa Otake
{"title":"Combined assessment of left ventricular and atrial function for transthyretin amyloid cardiomyopathy.","authors":"Arisa Senda, Hidekazu Tanaka, Momo Fujiwara, Koya Uemura, Yasushi Ichikawa, Shun Nagai, Yu Nishihara, Chihiro Fujii, Hiroshi Tsunamoto, Masayuki Kintsu, Terunobu Fukuda, Eriko Hisamatsu, Hiromasa Otake","doi":"10.1007/s00380-026-02729-5","DOIUrl":"10.1007/s00380-026-02729-5","url":null,"abstract":"<p><p>Transthyretin amyloid cardiomyopathy (ATTR-CM) is characterized by extracellular deposition of misfolded transthyretin protein in the myocardium, leading to progressive dysfunction of both the left ventricle (LV) and left atrium (LA). While LV impairment has traditionally been emphasized in risk stratification, emerging evidence suggests that LA dysfunction may also contribute significantly to clinical outcomes. However, the prognostic implications of combining both LV and LA functional assessments in ATTR-CM remain unknown. We retrospectively evaluated 139 patients with ATTR-CM treated with disease-modifying therapies. LV and LA function were assessed using global longitudinal strain (GLS) and LA reservoir strain via speckle-tracking echocardiography. Patients were categorized into three groups based on median GLS (10.9%) and LA strain (9.5%): (1) preserved both LV and LA function, (2) impaired both, and (3) preserved only one. The primary endpoint was a composite of cardiovascular death or hospitalization for heart failure, with a median follow-up of 1.50 years after treatment initiation. Patients with preserved function in both chambers experienced significantly fewer cardiovascular events, while those with impairment in both had the highest event rate. Patients with preserved function in only one chamber showed intermediate outcomes. In multivariable Cox regression analysis, combined LV and LA dysfunction was independently associated with adverse events (HR 8.89, 95% CI 2.38-44.20, P = 0.001). In conclusion, simultaneous evaluation of LV and LA function provides enhanced prognostic stratification in patients with ATTR-CM. This combined approach may support more accurate risk assessment and guide individualized therapeutic strategies in clinical practice.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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