{"title":"Impact of the Environmental and/or Modifiable Factors on the Clinical Characteristics of Cardiomyopathies.","authors":"Takashi Hiruma, Hiroyuki Morita","doi":"10.1536/ihj.25-298","DOIUrl":"https://doi.org/10.1536/ihj.25-298","url":null,"abstract":"","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 4","pages":"523-526"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753285","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":"Serial Optical Coherence Tomography Observations following Newer-Generation Drug-Eluting Stents That Combine Ultrathin Struts and Nanocoating in Patients with ST-Elevation Myocardial Infarction after Plaque Rupture.","authors":"Yosuke Oishi, Hiroyoshi Mori, Naoki Matsukawa, Kunihiro Ogura, Hiroaki Tsujita, Daisuke Yokokawa, Masashi Katagiri, Kengo Suzuki, Tomonori Yamashita, Shiori Fuse, Motoki Nakazawa, Taito Arai, Rikuo Sakai, Shunya Sato, Hideaki Tanaka, Ryota Masaki, Ryota Kosaki, Koshiro Sakai, Teruo Sekimoto, Seita Kondo, Shigeto Tsukamoto, Hidenari Matsumoto, Toshiro Shinke","doi":"10.1536/ihj.25-065","DOIUrl":"https://doi.org/10.1536/ihj.25-065","url":null,"abstract":"<p><p>Newer-generation drug-eluting stents (DES) that combine ultrathin struts and nanocoating (biodegradable polymer sirolimus-eluting stents, BP-SES) could improve vascular healing in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) over previous DES. However, its time course has not been elucidated.Patients with STEMI caused by plaque rupture who underwent primary PCI at our institution using BP-SES between June 2018 and August 2020 were eligible. Vascular responses were assessed by frequency-domain optical coherence tomography (OCT), which was serially performed before the final angiography (post-PCI), after 2 weeks (2W-OCT) and 1 year (1Y-OCT).A total of 24 patients with STEMI were finally assessed. The percentage of uncovered struts declined significantly at 1 year (post-PCI 61.7 ± 20.0%; 1Y-OCT 3.3 ± 3.3%; P < 0.0001). The percentage of malapposed struts also decreased significantly (% malapposed struts: post-PCI; 4.1 ± 3.6%: 1Y-OCT; 1.0 ± 2.3%, P< 0.0001). On the other hand, a total of 9 patients (37.5%) had at least 1 portion (> 3 mm length) of persistent malapposition (16.7%), late acquired malapposition (4.2%), or coronary evagination (16.7%) at 1 year. The site of late acquired malapposition was mostly at the culprit site, while the sites of persistent malapposition and evagination were not. None of the lesions showed signs of stent thrombosis.In conclusion, BP-SES implanted into culprit plaque ruptures in patients with STEMI showed fast vascular healing in the chronic phase, while subclinical malappositions and evaginations were not rare and showed dynamic changes.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 5","pages":"728-735"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206358","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}
Yuki Matsubara, Michiyo Yamano, Tetsuhiro Yamano, Takeshi Nakamura, Naohiko Nakanishi, Kan Zen, Hirokazu Shiraishi, Satoaki Matoba
{"title":"Effects of Transcatheter Atrial Septal Defect Closure in Elderly Patients with Long-Standing Persistent Atrial Fibrillation.","authors":"Yuki Matsubara, Michiyo Yamano, Tetsuhiro Yamano, Takeshi Nakamura, Naohiko Nakanishi, Kan Zen, Hirokazu Shiraishi, Satoaki Matoba","doi":"10.1536/ihj.25-244","DOIUrl":"https://doi.org/10.1536/ihj.25-244","url":null,"abstract":"<p><p>Although the safety and efficacy of transcatheter atrial septal defect (ASD) closure has been reported in elderly patients, postprocedural outcomes in elderly patients with long-standing persistent atrial fibrillation (AF) have not been fully assessed. The aim of this study was to elucidate the cardiac remodeling process and symptom improvement after transcatheter ASD closure in elderly patients with AF (AF-ASD) compared to those in sinus rhythm (SR-ASD).We enrolled 52 patients aged > 70 years out of 253 consecutive patients who underwent transcatheter ASD closure. We retrospectively analyzed serial echocardiograms, New York Heart Association (NYHA) functional classification, and plasma brain natriuretic peptide (BNP) levels from baseline to 1 year after the procedure.With respect to the right-sided chambers, significant reverse remodeling began immediately after the procedure and continued in both groups up to 1 year after the procedure. Left ventricular augmentation was comparable in both groups. Left atrial volume increase was prominent in the AF-ASD group, with a statistically significant difference compared with the SR-ASD group from 2 days to 1 year after the procedure (all P < 0.05). NYHA functional classification improved in both groups. Plasma BNP levels decreased only in the AF-ASD group from baseline to 1 year (median value [interquartile range], 336.2 pg/mL [145.1-491.4] to 173.8 pg/mL [73.6-261.7], P = 0.032).Transcatheter ASD closure is an effective treatment for heart failure in elderly patients with ASD and long-standing persistent AF.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 5","pages":"805-812"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206314","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":"Characteristics of Incident Coronary Artery Disease in Patients Undergoing Atrial Fibrillation Ablation.","authors":"Hiroyuki Ikeda, Kanae Hasegawa, Hiroyasu Uzui, Moe Mukai, Naoto Tama, Kentaro Ishida, Hiroshi Tada","doi":"10.1536/ihj.24-676","DOIUrl":"10.1536/ihj.24-676","url":null,"abstract":"<p><p>Few reports have provided detailed characteristics of incident coronary artery disease (CAD) and its risk factors in patients undergoing ablation (ABL) for atrial fibrillation (AF).Patients undergoing ablation for AF with no documented CAD were retrospectively studied at our institution. Patients were divided into 2 groups: those in whom significant stenosis was detected incidentally on coronary angiography (CAG) performed at the same time as ablation, and those without. The detection rate and its predictors were examined.Of the 550 patients, 20 had incidental CAD (detection rate: 3.6%). We compared the clinical data between these 20 patients (ABL-CAD group) and the 530 patients who displayed no significant stenosis on CAG. In multivariate analysis, age, hemoglobin A1c (HbA1c), and high-density lipoprotein cholesterol (HDL-chol) were predictive factors (odds ratio: 1.08, 2.43, 1.58, 95% CIs: 1.01-1.14, 1.53-3.86, 0.92-0.99; P = 0.014, 0.004, 0.024, respectively) for identification of CAD. Multivariate analysis based on cut-off values from receiver operating characteristic analysis identified age, HbA1c ≥ 6.1%, and HDL-chol ≤ 49 mg/dL as predictors (odds ratios: 1.06, 4.04, 3.07; 95% CIs: 1.00-1.12, 1.58-10.3, 1.1-8.01; P = 0.04, 0.01, 0.021, respectively). The area under the curve was significantly greater for age and HbA1c ≥ 6.1% and HDL-chol ≤ 49 mg/dL than for age alone (0.810 versus 0.672; P = 0.005).Patients undergoing ablation for AF appear likely to have CAD if HbA1c is ≥ 6.1% and HDL-chol is ≤ 49 mg/dL.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 2","pages":"220-225"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752608","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":"Myocardial Infarction Associated with a Giant Hiatal Hernia.","authors":"Satoshi Nakawatase, Yasuhiro Ichibori, Naoki Mori, Yoshiharu Higuchi","doi":"10.1536/ihj.24-500","DOIUrl":"10.1536/ihj.24-500","url":null,"abstract":"<p><p>An 81-year-old woman was admitted to our hospital due to dyspnea on exertion, attributed to severe aortic stenosis, and was scheduled for transcatheter aortic valve implantation (TAVI). The day before the procedure, she experienced chest pain radiating to the left shoulder after consuming a hospital meal that was large compared to her usual meal size. An electrocardiogram (ECG) in the supine position showed ST-segment elevation in leads II, III, aVF, and reciprocal ST-segment depression in leads V1-V4. Interestingly, these changes resolved when she was in the sitting position. Chest computed tomography (CT) revealed a giant hiatal hernia slipping under the heart, with no other abnormal findings. During the TAVI procedure, the supine position again triggered chest symptoms, and subsequent coronary angiography demonstrated disruption of the left circumflex coronary artery (LCx) in the middle portion. Following drainage of the gastric contents, the coronary flow in the LCx improved to normal levels. Cardiac enzymes, including CK-MB, were elevated after TAVI. These findings suggest that the giant hiatal hernia directly compressed the coronary artery, leading to LCx flow disturbance and myocardial infarction. This case report highlights that a hiatal hernia is a common condition in the elderly and can be a potential cause of ischemic heart disease. It underscores the importance of recognizing that the cardiac effects of a hiatal hernia can vary significantly depending on the morphology of the hernia and the position of the patient.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 2","pages":"323-326"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752417","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":"Reminiscence Therapy-Involved Care Program Alleviates Cognitive Impairment and Depression in Elderly Patients with Acute Coronary Syndrome Treated with Percutaneous Coronary Intervention.","authors":"Taihua Zhou, Peilin Dong, Yaoyao Hu, Jia Wang, Mengjiao Hu, Xiaoxiao Chen, Yan Yang, Ping Zhu","doi":"10.1536/ihj.24-637","DOIUrl":"10.1536/ihj.24-637","url":null,"abstract":"<p><p>Reminiscence therapy (RT) promotes cognitive and psychological health in elderly individuals. This study assessed the impact of the reminiscence therapy-involved care program (RTIC) on cognition, anxiety, depression, and satisfaction among patients with elderly acute coronary syndrome (ACS) who received percutaneous coronary intervention (PCI).In total, 152 elderly patients with ACS undergoing PCI were randomized into the RTIC (n = 76) and routine care (RC) (n = 76) groups to receive the corresponding 6-month interventions. The mini-mental state examination (MMSE) scores were evaluated at discharge (M0), 3rd month (M3), and 6th month (M6). The hospital anxiety and depression scale for anxiety/depression (HADS-A/HADS-D) and patient satisfaction scores were assessed at M0, 1st month (M1), M3, and M6.The MMSE score at M6 (27.6 ± 2.0 versus 26.7 ± 2.1, P = 0.011) increased, whereas the percentage of cognitive impairment at M6 (27.9% versus 44.8%, P = 0.042) declined in the RTIC group versus the RC group. Moreover, the RTIC group achieved a low HADS-D score at M3 (6.5 ± 2.0 versus 7.4 ± 2.6, P = 0.035) and M6 (6.3 ± 1.9 versus 7.2 ± 2.5, P = 0.016), but a similar HADS-A score and percentages of depression and anxiety at any assessment point versus the RC group. Patient satisfaction at M3 (82.3 ± 12.0 versus 77.7 ± 11.4, P = 0.020) and M6 (85.6 ± 11.0 versus 79.4 ± 12.0, P = 0.002) was higher in the RTIC group than in the RC group. In the subgroup analysis, patients with and without cognitive impairment at M0 and those with depression at M0 benefited from RTIC. RTIC promotes cognition, psychological health, and satisfaction among elderly patients with ACS undergoing PCI.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 2","pages":"293-301"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752422","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}
Feng Ju, Xianjie Zhang, Zhifu Zhao, Yuansheng Cao, An Xie, Leqiang Xia, Dan Zhou
{"title":"Aloperine Regulates Inflammation, Apoptosis, and Autophagy in H9C2 Rat Cardiomyoblast Cells After Excessive Hypoxia.","authors":"Feng Ju, Xianjie Zhang, Zhifu Zhao, Yuansheng Cao, An Xie, Leqiang Xia, Dan Zhou","doi":"10.1536/ihj.24-454","DOIUrl":"10.1536/ihj.24-454","url":null,"abstract":"<p><p>Myocardial infarction (MI) is a cardiovascular condition that leads to increased morbidity and mortality, impacting the quality of life of individuals. Aloperine (ALO), derived from Sophora alopecuroides L, has been recognized for its beneficial effects in treating various diseases by showcasing therapeutic properties. However, the precise protective mechanisms of ALO on hypoxia/reoxygenation (H/R) -induced damage in cardiomyocytes in vitro remain unclear. In this study, it was manifested that cell proliferation was weakened after H/R treatment, but this impact was offset after ALO treatment. Furthermore, cell apoptosis was heightened after H/R treatment, but this phenomenon was neutralized after ALO treatment. ALO relieved inflammation in H/R-treated H9C2 rat cardiomyoblast cells. Moreover, ALO strengthened autophagy in H/R-triggered H9C2 rat cardiomyoblast cells through enhancing the LC3II/LC3I level and the LC3B fluorescence intensity. Lastly, it was testified that ALO can rescue the weakened autophagy, the heightened cell apoptosis, and the augmented inflammation after CC treatment in H/R-mediated H9C2 rat cardiomyoblast cells. In conclusion, ALO regulated inflammation, apoptosis, and autophagy through AMPK/Nrf2 pathway in H9C2 rat cardiomyoblast cells after excessive hypoxia. This study suggested that ALO may be an underlying drug for MI therapy.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 1","pages":"157-163"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079797","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":"Relationship between Uric Acid and All-Cause and Cardiovascular Mortality in Individuals with Hypertension.","authors":"Tian-Ming Gan, Yingjie Yang, Guan-Lian Mo, Shi-Rong Wang, Shu-Hu Li, Jin-Yi Li","doi":"10.1536/ihj.24-220","DOIUrl":"https://doi.org/10.1536/ihj.24-220","url":null,"abstract":"<p><p>Hypertension is a common disease in the general population. Serum uric acid (SUA) levels have been linked to the occurrence and worsening of hypertension. However, it is unclear whether SUA has an impact on all-cause mortality (ACM) and cardiovascular mortality (CVM) in hypertensive individuals. This research aimed to assess the relation between SUA and mortality in a hypertensive population using data from the National Health and Nutrition Examination Survey (NHANES) database.The research comprised 13,363 hypertensive patients from NHANES during 2001-2018. A weighted Cox proportional risk model and restricted cubic spline (RCS) were used for the analysis.During the follow-up period among the 13,363 participants, there were 3,066 deaths from all causes, of which 846 were from CVD. After adjusting for variables, HRs and corresponding 95% CIs were calculated for different SUA categories (Q1: SUA < 285.5 μmol/L, Q2: 285.5 μmol/L ≤ SUA < 339.0 μmol/L, Q3: 339.0 μmol/L ≤ SUA < 404.5 μmol/L, Q4: SUA ≥ 404.5 μmol/L). The ACM was 1 (reference), 1.557 (1.387, 1.747), 1.312 (1.154, 1.492), and 1.393 (1.228, 1.580) (all P < 0.01); while the CVM was 1 (reference), 1.308 (1.043, 1.641) (P = 0.041), 1.182 (0.938, 1.490) (P = 0.261), and 1.151 (0.904, 1.464) (P = 0.410). The RCS showed that both high and low levels of SUA were related to an elevated risk of ACM and CVM in a population of hypertensive individuals.In hypertensive individuals, an elevated risk of both ACM and CVM is associated with high and low levels of SUA.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 3","pages":"427-435"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199007","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":"Optimal Therapeutic Strategy for Ventricular Septal Defect Closure in Extremely Preterm Infants with Chronic Lung Disease and Severe Pulmonary Hypertension.","authors":"Akari Sato, Mai Sekine, Hidenori Kawasaki, Masayo Kanai, Hirotaka Ishido, Yoichi Iwamoto, Hideaki Senzaki, Ayumu Masuoka, Fujito Numano, Jun Muneuchi, Norie Mitsushita, Satoshi Masutani","doi":"10.1536/ihj.25-197","DOIUrl":"https://doi.org/10.1536/ihj.25-197","url":null,"abstract":"<p><p>In preterm infants with large ventricular septal defects (VSD), severe chronic lung disease (CLD), and pulmonary hypertension (PH), hemodynamic instability may occur after open-heart surgery. The selection of first pulmonary artery banding or one stage VSD closure is a clinical issue. At present, no guidelines exist to support decision-making in this unique population. This study reports the case of a preterm infant with a gestational age of 23 weeks and 4 days, a birth weight of 540 g, and elevated immunoglobulin-M levels, who was successfully treated with pulmonary artery banding and subsequently VSD closure. Before pulmonary artery banding, the pulmonary-to-systemic blood flow ratio was 2.5 and pulmonary vascular resistance was 2.6 U·m<sup>2</sup> under general anesthesia with FiO<sub>2</sub> = 0.6. However, pulmonary artery banding preceded considering the severe CLD and the risk of PH crisis after cardiopulmonary bypass. In a review of the literature on preterm infants with VSD with CLD and PH, only five infants, including the one in this case, were found. One infant underwent pulmonary artery banding first and survived, and three infants underwent one-stage VSD closure, after which one died (trisomy 21) due to a postoperative PH crisis. Three of the five cases underwent tracheostomy. The selection of first pulmonary artery banding or one-stage VSD closure needs to be carefully considered on a case-by-case basis, taking into consideration the severity of the VSD with CLD and PH. A future registry study will be needed to review these cases and clarify the outcome of the two strategies.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 5","pages":"914-919"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206404","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":"Association Between Improvement in Left Ventricular Ejection Fraction and Prognosis of Patients with Cardiac Sarcoidosis.","authors":"Daichi Maeda, Yuya Matsue, Yudai Fujimoto, Taishi Dotare, Tsutomu Sunayama, Kenji Yoshioka, Takeru Nabeta, Yoshihisa Naruse, Takeshi Kitai, Tatsunori Taniguchi, Hidekazu Tanaka, Ryota Morimoto, Yuichi Baba, Tohru Minamino","doi":"10.1536/ihj.25-273","DOIUrl":"https://doi.org/10.1536/ihj.25-273","url":null,"abstract":"<p><p>Changes in the left ventricular ejection fraction (LVEF) of patients with cardiac sarcoidosis (CS) have been reported; however, the prognostic implications remain unknown. This study aimed to investigate the predictive factors for LVEF improvement in patients with CS and the association between LVEF improvement and prognosis. This was a post hoc analysis of the ILLUMINATE-CS registry, a multicenter retrospective study on CS. Patients with a baseline LVEF ≥ 50% were excluded. LVEF improvement was defined as the difference between the baseline and follow-up echocardiographic results. Patients were stratified based on tertiles of LVEF improvement: 1st (≤ 0%, least improved), 2nd (0-9%), and 3rd (> 9%, most improved) tertile groups. The primary outcome was all-cause mortality after follow-up echocardiography. Overall, 188 patients with CS (age: 62.1 ± 10.7 years; male proportion: 42.6%) were analyzed. In the multivariate linear regression analysis, narrower QRS duration, lower baseline LVEF, and no prescription of beta-blockers at baseline were independently associated with greater LVEF improvement. During the median follow-up period of 407 days, 26 deaths occurred. The Kaplan-Meier curves showed a significant difference between the 3 groups (log-rank test, P = 0.002). In the adjusted Cox proportional hazard analysis, the 1st and 2nd tertile groups showed progressively higher mortality rates than the 3rd tertile group. Independent of other variables, LVEF improvement as a continuous variable was associated with a lower mortality rate. Among patients with CS, LVEF improvement was significantly associated with favorable outcomes. LVEF should be monitored if baseline LVEF is decreased.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 5","pages":"786-793"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206428","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}