Heart and Vessels最新文献

{"title":"Trends in antithrombotic therapy and clinical outcomes for percutaneous coronary intervention in Japan following the 2020 JCS guideline focused update: findings from the SAKURA PCI2 Antithrombotic Registry.","authors":"Riku Arai, Nobuhiro Murata, Keisuke Kojima, Michiaki Matsumoto, Naoya Matsumoto, Tomoyuki Morikawa, Wataru Atsumi, Eizo Tachibana, Hironori Haruta, Takaaki Kogo, Yasunari Ebuchi, Kazumiki Nomoto, Masaru Arai, Ken Arima, Takashi Mineki, Yutaka Koyama, Koji Oiwa, Yasuo Okumura","doi":"10.1007/s00380-024-02493-4","DOIUrl":"10.1007/s00380-024-02493-4","url":null,"abstract":"<p><p>In April 2020, the Japanese Circulation Society updated guidelines recommending shortened dual antiplatelet therapy (DAPT) for patients at Japanese Version of the High Bleeding Risk (J-HBR), but the impact remains unclear. We conducted a prospective multicenter registry (SAKURA PCI2 Antithrombotic Registry) starting June 2020 (n = 1136), enrolling patients who underwent percutaneous coronary intervention (PCI). Planned DAPT duration, defined as short if less than 3 months, was based on patient background post-PCI and physicians' discretion. Planned short DAPT was used in 55.2% of patients, with a similar incidence of J-HBR (68.3% vs. 66.6%, p = 0.55) and a shorter actual DAPT duration (97 vs. 229 days, p < 0.001) compared with Planned non-short DAPT. Primary endpoints, major adverse cardiovascular and cerebrovascular events (MACCE) including all-cause death, non-fatal myocardial infarction, stent thrombosis, and stroke, and Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding (BARC-3/5), occurred similarly across groups (MACCE: 6.5% vs. 7.3%, p = 0.66; BARC-3/5: 3.7% vs. 2.2%, p = 0.14). Independent predictors of MACCE included age ≥ 75, Clinical Frailty Scale ≥ 4, and hemoglobin < 11. Age ≥ 75, severe chronic kidney disease, hemoglobin < 11, and platelets < 100,000 were linked to BARC-3/5. Among BARC 3/5 patients, 41.2% experienced bleeding after switching to single antiplatelet therapy. Planned short DAPT was implemented in 55.2% of patients, showing comparable thrombotic and bleeding outcomes to non-short DAPT.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"612-628"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785147","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":"Comparative analysis of heart rate variability indices from ballistocardiogram and electrocardiogram: a study on measurement agreement.","authors":"Naotake Yanagisawa, Bingwei Yao, Jianting Zhang, Yuji Nishizaki, Takatoshi Kasai","doi":"10.1007/s00380-024-02506-2","DOIUrl":"10.1007/s00380-024-02506-2","url":null,"abstract":"<p><p>Ballistocardiogram (BCG) captures minute vibrations generated by heart movements. These vibrations are converted into heart rate variability (HRV) indices, allowing their unobtrusive monitoring over extended periods, while reducing the burden on patients or subjects. In this study, to evaluate the agreement between the HRV indices, we compared the HRV indices estimated from the BCG device with those obtained from the gold standard electrocardiogram (ECG). Twenty-five healthy volunteers (mean age: 40.6 ± 12.8 years; 14 males and 11 females) rested in the supine position on a bed with a BCG device placed under a pillow while ECG electrodes were attached. BCG and ECG measurements were simultaneously recorded for 20 min. Five min of time-series data for the JJ and RR intervals obtained from BCG and ECG were converted into HRV indices. These indices included the time-domain measures (mean inter-beat intervals [IBIs], standard deviation of normal-to-normal intervals [SDNN], root mean square of successive differences [RMSSD], and percent of difference between adjacent normal RR intervals greater than 50 ms [pNN50]) and frequency-domain measures (normalized low-frequency [LF], high-frequency power [HF], and LF/HF ratio). Of the 25 individuals, data of 22 (mean age: 38.9 ± 12.3 years; 13 males and 9 females) were used to assess the agreement between the two methods, excluding 3 (1 male and 2 females) with frequent premature ventricular contractions observed on ECG. Correlations between measurements were examined using scatter plots and Pearson's product-moment correlation coefficients; in contrast, differences between measurements were evaluated using paired t-tests. The Bland-Altman analysis was used to assess the agreement. For the mean IBIs, the correlation coefficient was 0.999 (p < 0.001), and the limits of agreement ranged from - 8.35 to 11.70, with no evidence of fixed bias (p = 0.139) or proportional bias (p = 0.402), indicating excellent agreement. In contrast, the correlation coefficients for SDNN, RMSSD, and pNN50 were 0.931 (p < 0.001), 0.923 (p < 0.001), and 0.964 (p < 0.001), respectively, showing high correlations. However, a fixed bias was observed in RMSSD (p = 0.007) and pNN50 (p = 0.010), and a proportional bias in SDNN (p = 0.002). The correlation coefficients for LF, HF, and LF/HF ratio were approximately 0.7, indicating lower agreement owing to observed fixed and proportional biases. These results indicate that, while the degree of agreement varies among HRV indices, the JJ intervals measured from BCG can be used as a suitable alternative to the RR intervals from ECG.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"655-664"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822024","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":"Sex-specific outcomes in acute myocardial infarction-associated cardiogenic shock treated with and without V-A ECMO: a retrospective German nationwide analysis from 2014 to 2018.","authors":"Hendrik Willem Beckmeyer, Jannik Feld, Jeanette Köppe, Andreas Faldum, Patrik Dröge, Thomas Ruhnke, Christian Günster, Holger Reinecke, Jan-Sören Padberg","doi":"10.1007/s00380-024-02509-z","DOIUrl":"10.1007/s00380-024-02509-z","url":null,"abstract":"<p><p>Acute myocardial infarction-associated cardiogenic shock (AMICS) remains a condition with high mortality. Some patients require mechanical circulatory support (MCS) as their condition deteriorates. Sex-specific differences in risk factors and outcomes of cardiovascular disease have previously been described but are inconclusive regarding the use of MCS in AMICS. We aimed to investigate these with a focus on long-term outcomes. Health claim data from AOK - Die Gesundheitskasse (local health care funds) for patients hospitalized with AMICS between January 1, 2014, and December 31, 2015, was descriptively analyzed. Then, a Cox proportional hazards model was used to adjust for confounders. We analyzed 10,023 patients, of which 477 (4.8%) were treated with veno-arterial extra-corporeal membrane oxygenation (V-A ECMO). In-hospital mortality was high, but similar between treatments (V-A ECMO 59.1%, no V-A ECMO 56.6%). Women had a higher median age (78.9 years, IQR 13.8 vs. 71.8 years, IQR 17.9; p < 0.001), a different cardiovascular risk profile and in the conservatively treated patients underwent revascularization less often (69.2% vs. 77.1%; p < 0.001) than men did. In a multivariate analysis, female sex was not associated with lower survival (HR 1.03, CI 0.98-1.09; p = 0.233). V-A ECMO, however, was associated with lower survival in both sexes. We observed a low overall survival in follow-up after three years (no V-A ECMO: men 28.9% vs. women 21.7%, V-A ECMO: men 18.2% vs. women 17.0%). In conclusion, women with AMICS presented with a different risk profile, especially a higher age, and underwent guideline-recommended therapies such as revascularization less often than men. Female sex, however, was not associated with lower survival in a multivariate analysis. In-hospital mortality was high, regardless of treatment, and V-A ECMO was associated with lower survival in follow-up.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"559-569"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824188","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":"Timing of acute decompensated heart failure in patients with heart failure and mildly reduced ejection fraction.","authors":"Henning Johann Steffen, Noah Abel, Felix Lau, Alexander Schmitt, Marielen Reinhardt, Muharrem Akin, Thomas Bertsch, Jonas Rusnak, Kathrin Weidner, Michael Behnes, Ibrahim Akin, Tobias Schupp","doi":"10.1007/s00380-024-02505-3","DOIUrl":"10.1007/s00380-024-02505-3","url":null,"abstract":"<p><p>This study investigates the prognosis of acute decompensated heart failure (ADHF) on admission (i.e., primary ADHF) as compared to ADHF onset during course of hospitalization (i.e., secondary ADHF) in patients hospitalized with heart failure with mildly reduced ejection fraction (HFmrEF). Limited data regarding the prognostic impact of the timing of onset of ADHF is available. Consecutive patients with HFmrEF and ADHF were retrospectively included at one institution from 2016 to 2022. Patients with primary ADHF were compared to patients with secondary ADHF with regard to the primary endpoint all-cause mortality at 30 months. Kaplan-Meier, uni- and multivariable Cox proportional regression analyses were applied for statistics. From a total of 484 patients hospitalized with HFmrEF and ADHF, 67.98% (n = 329) were admitted with primary ADHF. Patients with secondary ADHF had higher rates of concomitant acute myocardial infarction, alongside with a higher extend of coronary artery disease. The risk of all-cause mortality at 30 months was not affected by the timing of ADHF (hazard ratio (HR) = 0.853; 95% confidence interval (CI) 0.653-1.115; p = 0.246). However, patients with primary ADHF were associated with a higher risk of HF-related rehospitalization at 30 months (HR = 2.513; 95% CI 1.555-4.065; p = 0.001), which was still evident after multivariable adjustment (HR = 2.347; 95% CI 1.418-3.883; p = 0.001). The timing of onset of ADHF was not associated with long-term mortality in HFmrEF, however primary ADHF was associated with a higher risk of HF-related rehospitalization.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"592-603"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004486","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":"Maintenance mechanism of paroxysmal atrial fibrillation from the activation occurring within the pulmonary vein: analysis using non-contact mapping.","authors":"Hiroshige Yamabe, Toshiya Soejima, Yurie Fukami, Kazuki Haraguchi, Taichi Okonogi, Keisuke Hirai, Ryota Fukuoka, Kyoko Umeji, Yoshiya Orita, Hisashi Koga, Tomohiro Kawasaki","doi":"10.1007/s00380-024-02502-6","DOIUrl":"10.1007/s00380-024-02502-6","url":null,"abstract":"<p><p>It is unclear how pulmonary veins (PVs) maintain paroxysmal atrial fibrillation (AF). To clarify the PV's arrhythmogenic role, we examined PV activation sequences during paroxysmal AF. Left superior PV (LSPV) endocardial non-contact mapping was performed after a right PV isolation in 13 paroxysmal AF patients. Activation sequences within the LSPV before and during left-sided PVs ablation were analyzed, and those in complex fractionated atrial electrogram (CFAE) areas were compared with those in non-CFAE areas. CFAEs were observed in the LSPV's proximal half (area; 8.8 ± 3.2cm²) occupying 19.9 ± 6.0% of LSPV. The number of pivoting activations, wave breaks, and fusions over CFAE areas were significantly higher than those over non-CFE areas (25.5 ± 9.3 vs. 4.5 ± 4.8 times/s, p < 0.0001; 9.1 ± 5.3 vs. 1.4 ± 1.8 times/s, p < 0.0001; 13.0 ± 4.6 vs. 5.4 ± 4.4 times/s, p < 0.0001). The conduction velocities in CFAE areas were significantly slower than in non-CFAE areas (0.6 ± 0.2 vs. 1.7 ± 0.8 m/s, p < 0.001). After delivery of ablation lesions around the left-sided PVs (13.2 ± 7.4 applications), the PV activation became organized with a loss of CFAE areas, and the frequency of the LSPV's pivoting activation, wave break, and fusion significantly decreased compared to that pre-ablation (7.3 ± 10.9 vs. 30.0 ± 11.6 times/s, p < 0.001; 2.1 ± 5.3 vs. 10.5 ± 6.2 times/s, p < 0.002; 6.0 ± 6.6 vs. 18.4 ± 8.2 times/s, p < 0.001). Subsequently, AF terminated before the left-sided PV isolation in all patients. In conclusion, high-frequency random reentry associated with pivoting activation, wave break, and fusion within the LSPV, observed mostly over CFAE areas, maintained AF. Linear ablation lesions around the PV suppressed random reentry, resulting in the loss of CFAEs and AF termination.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"636-646"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791517","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":"Three-year clinical outcomes of the Misago stent via transradial intervention for aorto-iliac arterial disease.","authors":"Yasuyuki Tsuchida, Naoki Hayakawa, Hiromi Miwa, Shinya Ichihara, Shunsuke Maruta, Shunichi Kushida","doi":"10.1007/s00380-025-02562-2","DOIUrl":"https://doi.org/10.1007/s00380-025-02562-2","url":null,"abstract":"<p><p>Transradial intervention (TRI) is increasingly used for EVT in these lesions, and the Misago bare nitinol stent (BNS) is compatible with this approach. However, clinical outcomes of the Misago stent via TRI have not yet been reported. Therefore, we evaluated the 3-year clinical outcomes of the Misago stent via TRI. We demonstrated the retrospective, single-center observational study included 348 aorto-iliac arteries in 255 patients treated between October 2019 and May 2023, with Rutherford classifications ranging from categories 1 to 6. The patients were divided into groups: those treated with other stent types via TFI (n = 231) and those treated with Misago stents (n = 117). Additionally, outcomes of patients treated with Misago stents via TRI (n = 72) were compared to those treated with Misago stents via TFI (n = 45). The primary endpoint was 3-year primary patency, and the secondary endpoints were clinically driven target lesion revascularization (CD-TLR), all-cause mortality, major amputation, cerebral infarction, and procedure-associated complications during hospitalization. The 3-year primary patency rate was not significantly different between the Misago stent and other stents (93.2% versus 91.8%, respectively; P = 0.78). Similarly, the 3-year primary patency rate of the Misago stent via TRI was comparable to that of the Misago stent via TFI (91.7% versus 95.6%, respectively; P = 0.44). The competing risks model with multivariate analysis showed that the Misago stent and TRI were not associated with 3-year TLR (hazard ratio [HR], 0.80; 95% confidence interval [CI],0.24-0.64; P = 0.71 and HR, 1.94; 95% CI,0.47-8.07; P = 0.36, respectively). Dialysis and TSAC II C-D were independent predictors of 3-year TLR (HR, 3.28; 95% CI, 1.50-7.18; P = 0.003 and HR, 2.70; 95% CI, 1.28-5.69; P = 0.009, respectively). The Misago stent via TRI for aorto-iliac arterial disease demonstrated acceptable 3-year clinical outcomes. Dialysis and TSAC II C-D were identified as predictors of 3-year TLR.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539971","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":"Early improvement of left ventricular dyssynchrony after percutaneous coronary intervention in patients with single chronic total occlusion vessel.","authors":"Yanci Liu, Shaoping Wang, Hongyu Peng, Jinghua Liu","doi":"10.1007/s00380-024-02507-1","DOIUrl":"10.1007/s00380-024-02507-1","url":null,"abstract":"<p><p>The effect of percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) on left ventricular dyssynchrony was unclear. Patients with one CTO vessel were included. Tissue Doppler imaging (TDI) was used to assess the left ventricular dyssynchrony index (DI) in twelve segments before and after successful CTO PCI. Multiple regression was used to identify independent correlates of DI reduction. Ninety one patients were included with the mean age of 62.04 years. 88(96.70%) had left ventricular DI more than 33. It decreased from 69.58 ± 28.35 to 43.38 ± 17.34 (P < 0.001) after successful CTO PCI. PCI of infarct-relative CTO was associated with less percentage of DI reduction (Coefficient [Coef.], 11.13; 95% confidence interval [CI], 2.33-19.93; P = 0.01). Higher initial DI was associated with more percentage of DI reduction (Coef., - 0.38; 95% CI - 0.52 to - 0.23; P < 0.001). Percentage of DI reduction was associated with ejection fraction (EF) improvement (Coef., - 1.45; 95% CI - 2.58 to - 0.33; P = 0.01). CTO PCI led to significant reduction in DI and improvement of EF, particularly in patients without myocardial infraction and severe dyssynchrony. CTO patients with evident left ventricular dyssynchrony or without a history of myocardial infarction may benefit from a more proactive revascularization strategy. The association between dyssynchrony reduction and long-term benefits of CTO PCI warrants further investigation.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"570-576"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909040","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":"One-year clinical outcomes of endovascular revascularization in patients with acute limb ischemia.","authors":"Hiromi Miwa, Naoki Hayakawa, Yasuyuki Tsuchida, Shinya Ichihara, Satoshi Hirano, Shunsuke Maruta, Kotaro Miyaji, Shunichi Kushida","doi":"10.1007/s00380-024-02500-8","DOIUrl":"10.1007/s00380-024-02500-8","url":null,"abstract":"<p><p>Urgent revascularization should be performed to patients with acute limb ischemia (ALI) unless the ischemia is irreversible. In patients with severe ALI and multiple morbidities, surgical revascularization is not feasible; however, endovascular revascularization (EVR) may be an option. This study aimed to examine 1-year clinical outcomes of EVR in patients with ALI and determine prognostic factors. We retrospectively examined 90 EVR procedures performed in 81 patients with ALI between January 2018 and February 2024. The primary endpoint was 1-year amputation-free survival (AFS). Multivariable logistic regression was performed to identify predictors of 1-year AFS. Fifty-one procedures were performed for severe ALI (56.7%). Fifty-six patient were ambulatory at the time of procedures (62.2%). The 1-year AFS rate was 59.7%. Multivariable analysis revealed that hypertension (adjusted hazard ratio [aHR] 0.14; 95% confidence interval [CI], 0.05-0.47; P = 0.0007), presence of blood flow of both tibial arteries after EVR (aHR 0.19; 95% CI, 0.03-0.93; P = 0.04), and presence of arterial flow below the ankle after EVR (aHR 0.29; 95% CI, 0.09-0.84; P = 0.022) were independently associated with a higher AFS rate. Aortic plaque was independently associated with a lower AFS rate (aHR 3.98; 95% CI, 1.55-9.90; P = 0.048). EVR may be an acceptable treatment of ALI even in non-ambulatory patients and those with severe ALI. Achieving adequate blood flow of both tibial arteries and below the ankle by performing EVR may be important for improving patient outcomes.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"647-654"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785142","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":"Post-discharge changes in nutritional status predict prognosis in patients with acute decompensated HFpEF from the PURSUIT-HFpEF Registry.","authors":"Takashi Kitao, Shungo Hikoso, Shunsuke Tamaki, Masahiro Seo, Masamichi Yano, Takaharu Hayashi, Akito Nakagawa, Yusuke Nakagawa, Yohei Sotomi, Daisaku Nakatani, Takahisa Yamada, Yoshio Yasumura, Yasushi Sakata","doi":"10.1007/s00380-024-02499-y","DOIUrl":"10.1007/s00380-024-02499-y","url":null,"abstract":"<p><p>Undernutrition has been identified as a poor prognostic factor in heart failure with preserved ejection fraction (HFpEF). This study aimed to evaluate the impact of changes in nutritional status from discharge to one year post-discharge on the prognosis of patients with HFpEF. Initially, 547 HFpEF cases were classified into a normal nutrition group (NN) (n = 130) and an undernutrition group (UN) (n = 417), according to Controlling Nutritional Status (CONUT) scores at discharge. These groups were further subdivided according to CONUT scores one year post-discharge into NN (G1, n = 88) and UN (G2, n = 42), and NN (G3, n = 147) and UN (G4, n = 270), respectively. The primary end point was defined as a composite of all-cause mortality or heart failure readmission after the visit one year post-discharge. Normal nutrition was defined as a CONUT score of 0 or 1, and undernutrition as a CONUT score of ≥ 2. We compared the incidence rates of the primary end point between G1 and G2, and G3 and G4, and identified predictors for abnormalization or normalization of CONUT score one year post-discharge, as well as covarying factors with change in CONUT. In a multivariable Cox proportional hazards model, abnormalization of CONUT score was associated with an increased risk of the primary end point (adjusted HR [hazard ratio]: 2.87, 95% CI [confidence interval]: 1.32-6.22, p = 0.008), while normalization of CONUT was associated with a reduced risk (adjusted HR: 0.40, 95% CI: 0.23-0.67, p < 0.001). In a multivariate logistic regression analysis of patients with normal nutrition at discharge, the Euro Qol 5 Dimension score was identified as an independent predictor for abnormalization of CONUT score one year post-discharge (OR: 0.06, 95% CI: 0.01-0.43, p = 0.023). Among patients with undernutrition at discharge, prior heart failure hospitalization was the independent predictor for normalization of CONUT score (OR: 0.36, 95% CI: 0.20-0.66, p < 0.001). In a multivariate linear regression analysis, independent covariates associated with changes in CONUT included hemoglobin (β = - 0.297, p < 0.001), C-reactive protein (β = 0.349, p < 0.001), and log NT-proBNP (β = 0.142, p < 0.001). Post-discharge abnormalization or normalization of CONUT scores has prognostic impact on patients with HFpEF. Changes in CONUT may independently correlate with changes in hematopoiesis, inflammation, and fluid retention.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"577-591"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800557","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":"Clinical characteristics and risk factors of cardiovascular disease in systemic lupus erythematosus patients.","authors":"Qiumei Liao, Yeping Zhong, Yalin Cheng, Xiuxiu Li","doi":"10.1007/s00380-024-02508-0","DOIUrl":"10.1007/s00380-024-02508-0","url":null,"abstract":"<p><p>To analyze the clinical characteristics of cardiovascular disease in systemic lupus erythematosus (SLE) patients and identify risk factors for predicting the occurrence of cardiovascular disease in SLE patients. Clinical data of 110 SLE patients were randomly selected from the Tongde Hospital of Zhejiang Province clinical medical record database, including 50 patients with cardiovascular disease and 60 patients without. Clinical data, blood biochemistry indicators, antibody detection results, and complement levels were collected. The receiver operating characteristic (ROC) curve was used to analyze the efficacy of these differential indicators in predicting the occurrence of cardiovascular disease in SLE patients. Univariate logistic regression analysis and multivariate logistic regression analysis showed that anti-ribosomal P protein, RNP/sm, IgG, IgM, serum creatinine, uric acid, and lipoprotein a were independent risk factors for cardiovascular disease in SLE patients (P < 0.05). The area under the curve (AUC) for predicting cardiovascular disease in SLE patients using IgG was 0.67, with low sensitivity of 44% and high specificity of 88.48%. The AUC for predicting cardiovascular disease in SLE patients using IgM was 0.67, with sensitivity of 76% and specificity of 55.17%. The AUC for predicting cardiovascular disease in SLE patients using serum creatinine was 0.73, with sensitivity of 68% and specificity of 78.33%. The AUC for predicting cardiovascular disease in SLE patients using uric acid was 0.69, with sensitivity of 52% and specificity of 81.67%. The AUC for predicting cardiovascular disease in SLE patients using lipoprotein a was 0.96, with high sensitivity of 96% and specificity of 91.67%. Levels of anti-ribosomal P protein, RNP/sm, IgG, IgM, serum creatinine, uric acid, and lipoprotein A are significantly altered in SLE patients with cardiovascular disease. These indicators can be used to predict the risk of cardiovascular disease in SLE patients.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"665-675"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885654","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}