F. Coppi , G. Pagnoni , C. Campani , F. Grossule , C. Vacchi , D. Giuggioli , A.V. Mattioli , G. Boriani
{"title":"Sjögren's syndrome and pulmonary hypertension: Exploring the intricate link with interstitial lung disease","authors":"F. Coppi , G. Pagnoni , C. Campani , F. Grossule , C. Vacchi , D. Giuggioli , A.V. Mattioli , G. Boriani","doi":"10.1016/j.ijcard.2025.133185","DOIUrl":"10.1016/j.ijcard.2025.133185","url":null,"abstract":"<div><h3>Background</h3><div>Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease commonly presenting with sicca symptoms and, in approximately one-third of cases, extra-glandular manifestations, including pulmonary involvement. Pulmonary hypertension (pH) is a recognized, though less frequently studied, complication in pSS, particularly in patients with interstitial lung disease (ILD). This study evaluates the prevalence of PH in pSS and the relationship between ILD and cardiovascular risk in this population.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 63 patients with pSS, diagnosed according to ACR/EULAR criteria. Among them, 24 patients (38.1 %) had ILD, with 9 presenting pulmonary fibrosis. Comprehensive evaluations were conducted, including 2D/3D echocardiography, HRCT, and pulmonary function tests. Right heart catheterization confirmed PH when indicated. Patients were categorized into pSS-ILD and pSS-noILD groups for comparative analysis.</div></div><div><h3>Results</h3><div>The cohort comprised 7 males (11.1 %) and 56 females (88.9 %), with a mean age of 69.1 ± 12.5 years. The prevalence of PH was low (1.6 %), with only one confirmed case via right heart catheterization, significantly below previous reports. Notably, pSS-ILD patients were older (77.1 ± 10.7 years) and diagnosed with pSS later (68.5 ± 12.6 years; <em>p</em> = 0.001) than pSS-noILD patients. Cardiovascular comorbidities, including arterial hypertension (32.8 %) and dyslipidemia (24.2 %), were more prevalent in pSS-ILD patients (<em>p</em> = 0.003 and <em>p</em> = 0.001, respectively). Pulmonary function tests revealed lower FVC (2.23 ± 0.70 vs. 2.98 ± 0.56; <em>p</em> = 0.004) and DLCO-Sb (3.87 ± 1.52 vs. 5.31 ± 1.26; <em>p</em> = 0.017) in pSS-ILD patients, indicating reduced lung function. Echocardiographic findings showed higher sPA<em>P</em> values (>35 mmHg) and reduced TAPSE/sPAP ratios in the pSS-ILD group (<em>p</em> = 0.028 and <em>p</em> = 0.026, respectively), suggesting early signs of right ventricular impairment.</div></div><div><h3>Conclusions</h3><div>PH prevalence in pSS is lower than previously reported, likely due to rigorous diagnostic criteria. Patients with pSS-ILD exhibit a higher risk of cardiovascular comorbidities and lung function decline. Echocardiographic monitoring of parameters like TAPSE/sPAP may aid in early PH detection, emphasizing the need for tailored management in pSS-ILD patients. Further studies are warranted to explore PH subtypes in diverse populations and to optimize follow-up protocols for at-risk patients.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"430 ","pages":"Article 133185"},"PeriodicalIF":3.2,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Association of fasting blood glucose with in-hospital mortality in acute coronary syndrome patients with different glycemic statuses: Findings from the CCC-ACS project","authors":"Chu Fan, Hangyu Yan, Kehang Lei, Dan Li, Shutong Dong, Yue Zhang, Yutong Cheng, Zhao Li, Zhizhong Li, Haiyan Qian, Ji Huang","doi":"10.1016/j.ijcard.2025.133184","DOIUrl":"10.1016/j.ijcard.2025.133184","url":null,"abstract":"<div><h3>Background</h3><div>Fasting blood glucose (FBG) is a significant risk factor for in-hospital mortality in acute coronary syndrome (ACS). This study examines the relationship between FBG levels and outcomes in ACS patients with different glycemic statuses.</div></div><div><h3>Methods and results</h3><div>Data from 50,365 ACS patients in the CCC-ACS Project (2014–2019) were analyzed in a prospective cohort study. Patients were categorized into three groups based on diabetes history and HbA1c levels: Group A (good), Group B (intermediate), and Group C (poor) glycemic status. A non-linear relationship between FBG and mortality was found. The lowest mortality risks were associated with FBG levels of 4.96 mmol/L (Group A), 5.71 mmol/L (Group B), and 7.44 mmol/L (Group C). Elevated FBG levels were linked to increased mortality risk in all groups: Group A (OR: 1.17), Group B (OR: 1.14), and Group C (OR: 1.10), all <em>p</em> < 0.001. The model showed moderate accuracy (AUC: 0.78 for Groups A/B, 0.80 for Group C)·In Group A, each unit increase in FBG raised the mortality risk by 1.08 times compared to Group B (OR: 1.08, 95 % CI: 1.03–1.14, <em>p</em> = 0.002) and by 1.07 times compared to Group C (OR: 1.07, 95 % CI: 1.03–1.12, p = 0.002).</div></div><div><h3>Conclusions</h3><div>In ACS patients, elevated FBG is an independent risk factor for in-hospital mortality, regardless of glycemic status. Different glycemic statuses have varied optimal glycemic targets. The effect of FBG on mortality differs across glycemic groups, with patients in good glycemic status facing the highest mortality risk as FBG increases.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"430 ","pages":"Article 133184"},"PeriodicalIF":3.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rethinking risk stratification for infective endocarditis in adults with congenital heart disease: Lessons for emergency medicine","authors":"Yalcin Golcuk","doi":"10.1016/j.ijcard.2025.133187","DOIUrl":"10.1016/j.ijcard.2025.133187","url":null,"abstract":"","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"430 ","pages":"Article 133187"},"PeriodicalIF":3.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A new predictive tool of ventricular arrhythmias and cardiac death in primary benign cardiac tumors in children","authors":"Juan Yang, Lijuan He, Dongwei Yuan","doi":"10.1016/j.ijcard.2025.133190","DOIUrl":"10.1016/j.ijcard.2025.133190","url":null,"abstract":"","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"430 ","pages":"Article 133190"},"PeriodicalIF":3.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Critical appraisal of “Risk and Predictors of First-Time Infective endocarditis in adult patients with congenital heart disease—A Nationwide, register-based study”","authors":"Fathimathul Henna , Zaryab Bacha , Umama Alam , Javed Iqbal","doi":"10.1016/j.ijcard.2025.133191","DOIUrl":"10.1016/j.ijcard.2025.133191","url":null,"abstract":"","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"430 ","pages":"Article 133191"},"PeriodicalIF":3.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matteo Pagnesi , Mauro Riccardi , Giulio Savonitto , Pietro Ameri , Simonetta Monti , Mauro Driussi , Piero Gentile , Claudia Specchia , Chiara Oriecuia , Marianna Adamo , Matteo Toma , Alberto Giannoni , Emma Di Poi , Luciana D'Angelo , Valentina Colombo , Veronica Vecchiato , Edoardo Airo , Massimo Imazio , Andrea Garascia , Gianfranco Sinagra , Carlo Mario Lombardi
{"title":"Sex differences in pulmonary arterial hypertension: Insights from the FOCUS-PAH registry","authors":"Matteo Pagnesi , Mauro Riccardi , Giulio Savonitto , Pietro Ameri , Simonetta Monti , Mauro Driussi , Piero Gentile , Claudia Specchia , Chiara Oriecuia , Marianna Adamo , Matteo Toma , Alberto Giannoni , Emma Di Poi , Luciana D'Angelo , Valentina Colombo , Veronica Vecchiato , Edoardo Airo , Massimo Imazio , Andrea Garascia , Gianfranco Sinagra , Carlo Mario Lombardi","doi":"10.1016/j.ijcard.2025.133180","DOIUrl":"10.1016/j.ijcard.2025.133180","url":null,"abstract":"<div><h3>Background</h3><div>Despite the higher incidence of pulmonary arterial hypertension (PAH) in women, sex differences in terms of clinical presentation and prognosis are still uncertain. We assess the impact of sex in patients with PAH.</div></div><div><h3>Methods</h3><div>Sex differences were evaluated in the multicenter FOCUS-PAH registry, that included patients diagnosed with PAH at 7 tertiary care centers between 2001 and 2022. Patients' characteristics and outcomes were compared in men vs. women, and factors independently associated with long-term outcomes were assessed. The primary endpoint was overall survival.</div></div><div><h3>Results</h3><div>Among 410 included patients, 273 (66.6 %) were women and 137 (33.4 %) were men. Despite similar age, men had more cardio-renal-metabolic comorbidities and history of HIV infection, whereas women had more connective tissue disorders and scleroderma, and worse functional capacity. Dual therapy was more commonly prescribed in women (39.9 % vs. 27.0 %). At multivariable Cox regression analysis, female sex was independently associated with a lower risk of all-cause mortality (adjusted hazard ratio 0.60, 95 % confidence interval 0.38–0.95, <em>p</em> = 0.031). Age, European Society of Cardiology (ESC) / European Respiratory Society (ERS) risk score, glomerular filtration rate and scleroderma were independently associated with long-term mortality in women, whereas only age and ESC/ERS risk score independently predicted this endpoint in men.</div></div><div><h3>Conclusions</h3><div>In this real-world registry, women represented 2 out of 3 patients with PAH and female sex was independently associated with a lower risk of mortality. There were differences in the variables associated with long-term mortality between sexes, suggesting that individualized approach to risk stratification should also include sex.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"430 ","pages":"Article 133180"},"PeriodicalIF":3.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiaoting Yang , Hui Wu , Di Liu , Gang Zhou , Dong Zhang , Yanfang Liu , Yi Li , Tian Zhou , Yan Xiong
{"title":"Dynamic glycemic monitoring and systemic inflammation assessment: New insights into plaque characteristics in acute myocardial infarction","authors":"Xiaoting Yang , Hui Wu , Di Liu , Gang Zhou , Dong Zhang , Yanfang Liu , Yi Li , Tian Zhou , Yan Xiong","doi":"10.1016/j.ijcard.2025.133189","DOIUrl":"10.1016/j.ijcard.2025.133189","url":null,"abstract":"","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"430 ","pages":"Article 133189"},"PeriodicalIF":3.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ankit Agrawal, Umesh Bhagat, Aro Daniela Arockiam, Elio Haroun, Michael Faulx, Milind Y. Desai, Wael Jaber, Venu Menon, Brian Griffin, Tom Kai Ming Wang
{"title":"Machine learning risk-prediction model for in-hospital mortality in Takotsubo cardiomyopathy","authors":"Ankit Agrawal, Umesh Bhagat, Aro Daniela Arockiam, Elio Haroun, Michael Faulx, Milind Y. Desai, Wael Jaber, Venu Menon, Brian Griffin, Tom Kai Ming Wang","doi":"10.1016/j.ijcard.2025.133181","DOIUrl":"10.1016/j.ijcard.2025.133181","url":null,"abstract":"<div><h3>Background</h3><div>Takotsubo cardiomyopathy (TC) is an acute heart failure syndrome characterized by transient left ventricular dysfunction, often triggered by stress. Data on risk scores predicting mortality in TC is sparse. We developed a machine-learning risk score model to predict in-hospital mortality in patients with TC.</div></div><div><h3>Methods</h3><div>The National Inpatient Sample (NIS) database 2016–2020 was queried to identify adult patients (≥18 years) with TC using ICD-10 code I51.81. The primary outcome was in-hospital mortality. The dataset was randomly split into training (70 %), validation (20 %), and testing (10 %) dataset. Model performance was assessed using the area under the curve (AUC) with 95 % confidence intervals (95 % CI).</div></div><div><h3>Results</h3><div>Amongst 38,662 TC patients identified [mean age 67.15 ± 14.17 years, female 32,089 (83 %)], 2499 (6.5 %) died. A novel risk score (0–127) was developed on age, race, Elixhauser comorbidity burden, history of hypertension, history of cardiac arrhythmia, presentation of cardiac arrest, cardiogenic shock, and acute kidney injury. Model AUCs (95 % CI) in the training, validation, and testing datasets were 0.809 (0.781–0.838), 0.809 (0.780–0.837), and 0.838 (0.820–0.856), respectively.</div></div><div><h3>Conclusion</h3><div>TC carries high morbidity and mortality. Our novel machine learning-based risk score is an important tool for risk stratification. External validation is needed to confirm these findings.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"430 ","pages":"Article 133181"},"PeriodicalIF":3.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pathophysiology of heart failure with preserved ejection fraction in overweight and obesity - Clinical and treatment implications.","authors":"Mariana M Rodrigues, L Menezes Falcão","doi":"10.1016/j.ijcard.2025.133182","DOIUrl":"https://doi.org/10.1016/j.ijcard.2025.133182","url":null,"abstract":"<p><p>Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome with vast prevalence worldwide. Despite recent advances in understanding its pathophysiology, HFpEF remains under-diagnosed in clinical practice. Obesity-related HFpEF is a distinct and frequent phenotype with an additionally challenging diagnosis. We address the importance of overweight and obesity in HFpEF, focusing on the influence of adipose tissue in inflammation and neurohormonal activity. We also discuss atrial and ventricular remodelling in obesity-related HFpEF and potential clinical implications. Obesity is an independent risk factor for HFpEF. Adipose tissue synthesizes aldosterone, causing lower levels of natriuretic peptide. Adipocytes dysfunction promotes a pro-inflammatory state and leads to extracellular matrix remodelling and consequently stiffening of the heart and vessels. Thus, the quantity, distribution and quality of the excess fat influences cardiovascular risk. Visceral and epicardial adipose tissue are often associated with an increased likelihood of developing HFpEF. Obesity-related HFpEF presents higher risk of left ventricular concentric remodelling and inadequate accommodation of the expanded volume due to the obesity, resulting in higher left ventricular filling pressure. Nevertheless, microvascular endothelium inflammation modifies cardiomyocyte elasticity and increases collagen deposition, which enhances myocardial fibrosis and results in HFpEF. Furthermore, neurohormonal activation may also contribute to cardiac remodelling by inducing plasma volume expansion. In turn, leptin also stimulates aldosterone synthesis and enhances renin-angiotensin-aldosterone system. Obesity-related HFpEF presents worse overall prognosis, with increased risk of heart failure hospitalization and all-cause mortality. Intentional weight loss through caloric restriction, physical activity, pharmacological intervention and/or bariatric surgery are promising strategies.</p>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":" ","pages":"133182"},"PeriodicalIF":3.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}