Heart and Vessels最新文献

{"title":"Thyroid function, coronary complexity, and socio-demographic determinants of outcomes after acute coronary syndrome: sex-specific analysis from the CaRD registry.","authors":"Ivana Jurin, Karlo Gjuras, Maja Banović, Tea-Terezija Cvetko, Ana Matijaca, Irzal Hadžibegović, Kristina Marić Bešić, Šime Manola, Hrvoje Jurin, Diana Rudan, Zrinka Šakić, Jozica Šikić","doi":"10.1007/s00380-026-02678-z","DOIUrl":"10.1007/s00380-026-02678-z","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"715-728"},"PeriodicalIF":1.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147467851","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}

{"title":"Factors associated with serum GDF-15, iron deficiency and lower hemoglobin levels in patients with chronic heart failure and healthy elderly people.","authors":"Taira Fukuda, Seiko Tokoi, Riichi Nishikawa, Takaaki Hasegawa, Kan Kondo, Ryo Kayashima, Kaori Kono, Shu Inami, Hirohisa Amano, Takuo Arikawa, Hiroshi Yagi, Suomi Yamaguchi, Masashi Sakuma, Shigeru Toyoda, Toshiaki Nakajima","doi":"10.1007/s00380-026-02775-z","DOIUrl":"https://doi.org/10.1007/s00380-026-02775-z","url":null,"abstract":"<p><strong>Background: </strong>Coexistent chronic heart failure and iron deficiency is frequently encountered in clinical practice and affects prognosis. We investigated factors associated with serum growth differentiation factor (GDF)-15, iron deficiency and lower hemoglobin levels in patients with heart failure and healthy elderly individuals.</p><p><strong>Methods and results: </strong>Blood tests were performed on 90 patients with heart failure (aged 75.0 ± 10.7 years) and 73 healthy elderly individuals (aged 76.3 ± 6.4 years). Serum GDF-15, tumor necrosis factor (TNF) α, N-terminal pro-brain natriuretic peptide (NT-proBNP), and hepcidin concentrations were measured using enzyme-linked immunosorbent assay. Left atrial volume index (LAVI) was measured by echocardiography. Hemoglobin (Hb) in healthy elderly individuals correlated with serum iron and hepcidin. In contrast, Hb in patients with heart failure correlated with serum iron and GDF-15. Serum GDF-15 concentration in healthy elderly subjects correlated with estimated glomerular filtration rate, serum iron, and hepcidin. In contrast, in patients with heart failure, it correlated with NT-proBNP and TNFα. In patients with heart failure, serum iron correlated with LAVI.</p><p><strong>Conclusions: </strong>Lower hemoglobin levels in patients with heart failure might be associated with elevated serum GDF-15 due to higher serum NT-proBNP and inflammation, as well as iron deficiency. In contrast, lower hemoglobin levels in healthy elderly individuals might involve lower serum iron and hepcidin levels. Lower serum iron concentration was suggested to be involved in left atrial remodeling in patients with heart failure.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223906","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}

{"title":"Effects of inhaled nitric oxide during mechanical circulatory support: a prospective pilot study.","authors":"Masataka Hiruma, Shuichiro Kurita, Yosuke Kawai, Mitsuhiro Watanabe, Ryohei Sakai, Takeshi Kashimura, Keitaro Domae, Seiichi Yamashima, Hiroyuki Honda, Kei Nishiyama","doi":"10.1007/s00380-026-02773-1","DOIUrl":"https://doi.org/10.1007/s00380-026-02773-1","url":null,"abstract":"<p><p>Among patients with cardiogenic shock receiving Impella-based mechanical circulatory support, pulmonary vascular load and right ventricular dysfunction may affect left ventricular preload and device flow. Prospective data on the acute hemodynamic effects of inhaled nitric oxide (iNO) in this setting are limited. We evaluated short-term hemodynamic changes after iNO initiation in patients receiving Impella or Impella combined with veno-arterial extracorporeal membrane oxygenation (ECPELLA) support. We conducted a prospective single-center pilot study of adult patients receiving Impella or ECPELLA support who were treated with iNO. iNO was initiated at 20 ppm after initial circulatory resuscitation once pulmonary artery pulse pressure could be reliably assessed. Hemodynamic variables were recorded immediately before iNO initiation (T0) and 30 min (T1) and 24 h (T2) after initiation. The primary endpoint was the change in mean pulmonary artery pressure (mPAP) from T0 to T1. We enrolled 11 patients, and 10 were analyzed. mPAP decreased from 19.0 (14.8-20.3) mmHg at T0 to 16.5 (12.8-19.3) mmHg at T1 (P = 0.004). The T0-T2 difference was not significant. Lactate levels decreased, but this temporal change could not be attributed directly to iNO without a control group. Methemoglobin levels increased slightly at T2 without clinical methemoglobinemia. iNO was temporally associated with an early reduction in mPAP in patients receiving Impella-based support, without clear improvement in systemic hemodynamic indices. These hypothesis-generating findings require confirmation in larger controlled studies.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223908","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}

{"title":"Clinical impact of admission estimated glomerular filtration rate categories in patients with acute myocardial infarction.","authors":"Hiroyoshi Mori, Kazuki Fukui, Kouichi Tamura, Atsuo Maeda, Yoshihiro Akashi, Junya Ako, Yuji Ikari, Toshiaki Ebina, Atsuo Namiki, Ichiro Michishita, Kazuo Kimura, Hiroshi Suzuki","doi":"10.1007/s00380-026-02768-y","DOIUrl":"https://doi.org/10.1007/s00380-026-02768-y","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is a well-established risk factor in acute myocardial infarction (AMI); however, the clinical relevance of admission estimated glomerular filtration rate (eGFR)-based categories remains unclear. We analyzed 10,870 patients from a prospective multicenter AMI registry in Japan. Patients were stratified into stages 1 (≥ 90), 2 (60-89), 3a (45-59), 3b (30-44), 4 (15-29), and 5 (< 15 mL/min/1.73 m²) based on the admission eGFR. The primary endpoint was 30-day major adverse cardiovascular events (MACE), defined as cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke. Bleeding was defined as BARC type 3 or 5. More advanced admission eGFR stages were associated with a higher risk of adverse events. After multivariable adjustment, stages 4 and 5 were associated with a significantly higher risk of MACE compared with the reference group of stages 1 and 2 (stage 4: HR 2.12, 95% CI 1.03-4.33; stage 5: HR 4.14, 95% CI 1.54-11.09), whereas stages 3a and 3b were not significantly associated with MACE. In patients with AMI, clinical outcomes varied across admission eGFR categories, with more advanced renal dysfunction, particularly stages 4 and 5, associated with a higher risk of short-term MACE. Detailed categorization of admission eGFR may provide additional prognostic information for early risk assessment.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181405","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}

{"title":"Component-level associations of anemia and renal dysfunction with competing first events in acute heart failure with atrial fibrillation.","authors":"Jumpei Yamamoto, Keijiro Nakamura, Hiromasa Hayama, Yoshinari Enomoto, Masaya Yamamoto, Hisao Hara, Yukio Hiroi, Hidehiko Hara","doi":"10.1007/s00380-026-02766-0","DOIUrl":"https://doi.org/10.1007/s00380-026-02766-0","url":null,"abstract":"<p><p>In acute heart failure (AHF) with atrial fibrillation (AF), major bleeding, ischemic stroke, and death compete as the first clinical event. Whether anemia and renal dysfunction together define a single bleeding-risk construct is unclear. We retrospectively analyzed 712 consecutive patients hospitalized with AHF and AF in a multicenter registry (2014-2020). Hemoglobin < 12 g/dL and creatinine clearance (CrCl) < 50 mL/min defined four mutually exclusive groups. Fine-Gray models evaluated bleeding-first, stroke-first, and death-first events, with hemoglobin and CrCl also entered simultaneously as continuous covariates. Incremental value for 365-day bleeding-first was assessed in one common cohort with bootstrap optimism correction. Of 712 patients (mean age 79.1 years; 48.6% female; 81.7% on oral anticoagulants), 138 had neither abnormality, 40 anemia only, 236 renal dysfunction only, and 298 both. Bleeding occurred first in 81 patients (11.4%), stroke in 43 (6.0%), and death in 140 (19.7%). Adjusted bleeding-first risk was highest with both abnormalities (subdistribution hazard ratio [sHR] 3.67; 95% confidence interval [CI] 1.39-9.68; p = 0.009 versus neither), but neither the contrast against anemia only (sHR 2.42; 95% CI 0.74-7.91; p = 0.14) nor the anemia × renal dysfunction interaction (p = 0.98) was significant. Modeled continuously, lower hemoglobin was associated with bleeding-first (sHR 1.22 per 1 g/dL decrease; 95% CI 1.06-1.40; p = 0.006) and lower CrCl with death-first (sHR 1.20 per 10 mL/min decrease; 95% CI 1.07-1.35; p = 0.002). Relative to the model with anemia alone, neither adding renal dysfunction (optimism-corrected change in area under the curve [ΔAUC] 0.0138; 95% CI - 0.0473 to 0.0576) nor using the combined binary phenotype (0.0145; 95% CI - 0.0168 to 0.0432) showed clear improvement in prediction. The bleeding association persisted in anticoagulated patients and after excluding bleeding supported only by a hemoglobin fall. Although patients with both anemia and renal dysfunction had the highest observed bleeding-first risk, their coexistence showed neither a supported interaction nor improved 365-day prediction beyond anemia alone. Lower hemoglobin and lower CrCl showed different observed association patterns across the competing first events, favoring component-level interpretation over a unitary anemia-renal risk construct.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108420","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}

{"title":"Two-year clinical outcomes of jetstream atherectomy followed by drug-coated balloon angioplasty for severely calcified femoropopliteal lesions.","authors":"Takuya Tsujimura, Daichi Yoshii, Yosuke Hata, Yoshiteru Okina, Taku Toyoshima, Hitoshi Minamiguchi, Yasuhiro Ichibori, Kei Nakamoto, Naoki Mori, Takashi Kanda, Hiromi Tsutsui, Mikiko Matsumura, Satoshi Nakawatase, Takashige Sakio, Yuki Shibuya, Shinya Minami, Ken Koda, Koichi Ochi, Takuma Kanayama, Shin Okamoto, Osamu Iida","doi":"10.1007/s00380-026-02760-6","DOIUrl":"https://doi.org/10.1007/s00380-026-02760-6","url":null,"abstract":"<p><p>Severely calcified femoropopliteal (FP) lesions in patients with symptomatic peripheral artery disease (PAD) remain challenging in endovascular therapy (EVT). Although the Jetstream™ atherectomy system is a plaque-modifying device capable of debulking calcified plaque, long-term real-world data are limited. This study aimed to evaluate the 2-year clinical outcomes of EVT using Jetstream™ atherectomy followed by drug-coated balloon (DCB) angioplasty for severely calcified FP lesions. This multicenter retrospective observational study included 147 limbs from 126 patients with symptomatic PAD who underwent EVT using Jetstream™ atherectomy followed by DCB angioplasty between September 2022 and November 2025. Lesions requiring bailout stenting or including in-stent restenosis were excluded. The primary endpoint was 2-year primary patency. Time-to-event outcomes were assessed using the Kaplan-Meier method, and predictors of restenosis were evaluated using Cox proportional hazards regression analysis. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal postprocedural minimum lumen area (MLA) cutoff. Primary patency rates were 74.2% at 1 year and 49.0% at 2 years. Multivariate analysis identified a history of prior EVT and smaller postprocedural MLA as independent predictors of 2-year restenosis. ROC analysis demonstrated that a postprocedural MLA cutoff of 12.6 mm² best predicted restenosis. In patients with severely calcified FP lesions, Jetstream™ atherectomy followed by DCB angioplasty was associated with limited 2-year primary patency in this high-risk population.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108488","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}

{"title":"Authors' reply to \"Plaque vulnerability or lesion geometry? Interpreting CT-derived translesional gradients\".","authors":"Kazuyoshi Kakehi, Masafumi Ueno, Masaru Kayama, Kei Hamanaka, Haruka Minami, Nobuhiro Yamada, Kyohei Onishi, Keishiro Sugimoto, Yohei Funauchi, Takayuki Kawamura, Kosuke Fujita, Koichiro Matsumura, Gaku Nakazawa","doi":"10.1007/s00380-026-02770-4","DOIUrl":"https://doi.org/10.1007/s00380-026-02770-4","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108415","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}

{"title":"Prognostic significance of high Lipoprotein(a) levels in patients with coronary artery spasm.","authors":"Woo Jin Ahn, Seung-Woon Rha, Byoung Geol Choi, Se Yeon Choi, Jae Kyeong Byun, Youjin Lee, Manda Satria Chesario, Melly Susanti, Wonsang Chu, Jieun Lee, Soohyung Park, Eun Jin Park, Dong Oh Kang, Cheol Ung Choi, Chang Gyu Park, Dong Joo Oh","doi":"10.1007/s00380-026-02669-0","DOIUrl":"10.1007/s00380-026-02669-0","url":null,"abstract":"<p><p>Lipoprotein(a) [Lp(a)] has recently regained attention in prognostic research. However, data remain limited for patients without significant coronary artery stenosis confirmed angiographically and those who do not undergo percutaneous coronary intervention (PCI), and studies focusing specifically on patients with coronary artery spasm (CAS) are even more scarce. In this study, a total of 1,373 patients with positive intracoronary provocation testing with acetylcholine (ACH) and insignificant coronary artery stenosis were divided into two groups based on Lp(a) levels: the high Lp(a) group (≥50 mg/dL) and the low Lp(a) group (< 50 mg/dL). The primary endpoint was major adverse cardiovascular events (MACE); secondary endpoints included major adverse cardiovascular and cerebrovascular events (MACCE1) and MACCE1 with recurrent angina (MACCE2). Multiple imputation was followed by inverse probability of treatment weighting (IPTW), and Cox regression analysis was used to analyze 10-year clinical outcomes. There was no significant difference in MACE, MACCE1, or MACCE2 between the two groups. Before IPTW adjustment, the high Lp(a) group had a higher incidence of revascularization (0.9% vs. 3.3%; p = 0.033), but this difference was not significant after IPTW adjustment (p = 0.118). Although there was no significant group difference, a notable proportion of patients experienced recurrent angina requiring angiography (25.3% vs. 30.8%; p = 0.615). In conclusion, although Lp(a) is an established independent risk factor, it did not show prognostic significance in CAS patients in the absence of significant coronary artery stenosis and PCI.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"663-672"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981520","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}

{"title":"Clinical significance of urinary sodium measurement for predicting pulmonary decongestion: a prospective observational study.","authors":"Mitsutoshi Oguri, Takahiro Okumura, Satoshi Kojima, Soichiro Maeda, Satoya Yoshida, Yuichiro Koyama, Tomoya Ishiguro, Yusuke Fujikawa, Hiroshi Takahashi, Toyoaki Murohara, Hideki Ishii","doi":"10.1007/s00380-026-02667-2","DOIUrl":"10.1007/s00380-026-02667-2","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"673-684"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283112","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}

{"title":"Comment on \"Incidence and predictors of postoperative atrial fibrillation in patients with preoperative sinus rhythm undergoing cardiac or aortic surgery\".","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1007/s00380-025-02625-4","DOIUrl":"10.1007/s00380-025-02625-4","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"709-710"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145695786","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}