Journal of Cardiovascular Development and Disease最新文献

{"title":"Thirty-Day and One-Year All-Cause Mortality of ST-Segment Elevation Myocardial Infarction in Johannesburg, South Africa: Insights from the STEMI HOC-1 Prospective Study.","authors":"Marheb Badianyama, Arthur Mutyaba, Nqoba Tsabedze","doi":"10.3390/jcdd12080282","DOIUrl":"10.3390/jcdd12080282","url":null,"abstract":"<p><p>Despite the increased mortality due to ST-segment elevation myocardial infarction (STEMI) in South Africa (SA), SA lacks comprehensive data on STEMI clinical outcomes. This study aimed to determine the 30-day and one-year all-cause mortality rates of STEMI patients presenting to our hospital. This was a one-year prospective single-centre study of STEMI patients presenting to the Charlotte Maxeke Johannesburg Hospital in SA between December 2021 and August 2023. We compared the baseline clinical characteristics, reperfusion strategies, and in-hospital, 30-day, and one-year clinical outcomes of survivors and non-survivors. This cohort included 378 STEMI participants. The in-hospital, 30-day, and one-year all-cause mortality rates were 6.6% (n = 25), 10.1% (n = 38), and 17.2% (n = 65), respectively. The pharmacoinvasive strategy was the most used reperfusion therapy (n = 150, 39.7%). On adjusted multivariate Cox regression analysis, a Killip class >2 was the strongest independent predictor of 30-day [HR 5.61, 95% CI 2.83-11.12; <i>p</i> < 0.001] and one-year all-cause mortality [HR 1.72, 95% CI 1.26-2.34; <i>p</i> = 0.001]. Although mortality has increased, our mortality rates were comparable to outcomes from high-income countries but significantly lower than reports from other low- or middle-income countries. Importantly, there were no significant differences in 30-day and one-year survival outcomes between the different reperfusion strategies.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 8","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12387001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955577","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":"Impact of Intrapericardial Fluid on Lesion Size During Epicardial Radiofrequency Ablation: A Computational Study.","authors":"Luis Cuenca-Dacal, Marcela Mercado-Montoya, Tatiana Gómez-Bustamante, Enrique Berjano, Maite Izquierdo, José M Lozano, Juan J Pérez, Ana González-Suárez","doi":"10.3390/jcdd12080283","DOIUrl":"10.3390/jcdd12080283","url":null,"abstract":"<p><strong>Background and aims: </strong>Epicardial RFA is often required when ventricular tachyarrhythmias originate from epicardial or subepicardial substrates that cannot be effectively ablated endocardially. Our objective was to evaluate the impact of intrapericardial fluid accumulation on the lesion size in the myocardium and the extent of thermal damage to adjacent structures, particularly the lung.</p><p><strong>Methods: </strong>An in silico model of epicardial RFA was developed, featuring an irrigated-tip catheter placed horizontally on the epicardium. A 50 W-30 s RF pulse was simulated. Temperature distributions and resultant thermal lesions in both the myocardium and lung were computed.</p><p><strong>Results: </strong>An increase in pericardial space from 2.5 mm to 4.5 mm resulted in a reduction of myocardial lesion depth by up to 1 mm, while the volume of lung damage decreased from 200 to 300 mm³ to nearly zero, irrespective of myocardial or epicardial fat thickness. Myocardial lesion size was markedly influenced by the thickness of the epicardial fat layer. In the absence of fat and with a narrow pericardial space, lesions reached up to 262 mm³ in volume and 6.1 mm in depth. With 1 mm of fat, lesion volume decreased to below 100 mm³ and depth to 3 mm; with 2 mm, to under 40 mm³ and 2 mm; and with 3 mm, to less than 16 mm³ and 1.2 mm. Lung damage increased moderately with greater fat thickness. Cooling the irrigation fluid from 37 °C to 5 °C reduced lung damage by up to 51%, while myocardial lesion size decreased by only 15%.</p><p><strong>Conclusions: </strong>Intrapericardial fluid accumulation can limit myocardial lesion formation while protecting adjacent structures. Cooling the irrigation fluid may reduce collateral damage without compromising myocardial lesion depth.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 8","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12387105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955439","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":"Sinus Tachycardia and Unrelieved Wall Stress Precede Left Ventricular Systolic Dysfunction During Preclinical Cardiomyopathic Changes in Duchenne Muscular Dystrophy.","authors":"Takeshi Tsuda, Amy Walczak, Karen O'Neil","doi":"10.3390/jcdd12080280","DOIUrl":"10.3390/jcdd12080280","url":null,"abstract":"<p><strong>Background: </strong>The onset of cardiomyopathy in Duchenne muscular dystrophy (DMD) is insidious and poorly defined. We proposed integrated wall stress (iWS) as a marker of total left ventricular (LV) workload and tested whether the increased iWS represents early DMD cardiomyopathy.</p><p><strong>Methods: </strong>Peak systolic wall stress (PS-WS) was calculated in M-mode echocardiography with simultaneous blood pressure measurement. iWS was defined as a product of PS-WS and heart rate (HR) divided by 60 (=PS-WS/RR interval). We measured iWS in normal controls (CTRL), DMD with normal LV shortening fraction (%LVSF ≥ 30%) (DMD-A), and DMD with decreased %LVSF (<30%) (DMD-B).</p><p><strong>Results: </strong>40 CTRL and 79 DMD patients were studied. Despite comparable %LVSF, both HR and iWS were significantly higher in DMD-A (n = 50) than in CTRL (<i>p</i> < 0.0001). iWS was significantly higher in DMD-B (n = 29) than in DMD-A (<i>p</i> < 0.0001) despite comparable HR. PS-WS was significantly higher in DMD-A than in CTRL and higher in DMD-B than in DMD-A, suggesting high HR is not a sole determinant of increased iWS in DMD-A compared with CTRL. In a longitudinal study in 35 DMD patients over 4.0 ± 2.0 years, iWS showed significant increase (<i>p</i> = 0.0062) alongside a significant decline in %LVSF (<i>p</i> < 0.0001).</p><p><strong>Conclusions: </strong>iWS significantly increased in DMD before %LVSF declined. The progressive increase of iWS in DMD is initially associated with increased HR and then with increased PS-WS. iWS may serve as a useful echocardiographic marker in identifying preclinical DMD cardiomyopathy.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 8","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12387109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955555","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":"Genetic Architecture of Ischemic Stroke: Insights from Genome-Wide Association Studies and Beyond.","authors":"Ana Jagodic, Dorotea Zivalj, Antea Krsek, Lara Baticic","doi":"10.3390/jcdd12080281","DOIUrl":"10.3390/jcdd12080281","url":null,"abstract":"<p><p>Ischemic stroke is a complex, multifactorial disorder with a significant heritable component. Recent developments in genome-wide association studies (GWASs) have identified several common variants associated with clinical outcomes, stroke subtypes, and overall risk. Key loci implicated in biological pathways related to vascular integrity, lipid metabolism, inflammation, and atherogenesis include 9p21 (<i>ANRIL</i>), <i>HDAC9</i>, <i>SORT1</i>, and <i>PITX2</i>. Although polygenic risk scores (PRSs) hold promise for early risk prediction and stratification, their clinical utility remains limited by Eurocentric bias and missing heritability. Integrating multiomics approaches, such as functional genomics, transcriptomics, and epigenomics, enhances our understanding of stroke pathophysiology and paves the way for precision medicine. This review summarizes the current genetic landscape of ischemic stroke, emphasizing how evolving methodologies are shaping its prevention, diagnosis, and treatment.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 8","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12386999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955424","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":"Fractional Flow Reserve from Coronary CT: Evidence, Applications, and Future Directions.","authors":"Arta Kasaeian, Mohadese Ahmadzade, Taylor Hoffman, Mohammad Ghasemi-Rad, Anoop Padoor Ayyappan","doi":"10.3390/jcdd12080279","DOIUrl":"10.3390/jcdd12080279","url":null,"abstract":"<p><p>Coronary computed tomography angiography (CCTA) has emerged as the leading noninvasive imaging modality for the assessment of coronary artery disease (CAD), offering high-resolution visualization of the coronary anatomy and plaque characterization. The development of fractional flow reserve derived from CCTA (FFR-CT) has further transformed the diagnostic landscape by enabling the simultaneous evaluation of both anatomical stenosis and lesion-specific ischemia. FFR-CT has demonstrated diagnostic accuracy comparable to invasive FFR. The combined use of CCTA and FFR-CT is now pivotal in a broad range of clinical scenarios, including the evaluation of stable and acute chest pain, assessment of high-risk and complex plaque features, and preoperative planning. As evidence continues to mount, CCTA and FFR-CT are positioned to become the primary gatekeepers to the cardiac catheterization laboratory, potentially reducing the number of unnecessary invasive procedures. This review highlights the growing clinical utility of FFR-CT, its integration with advanced plaque imaging, and the future potential of these technologies in redefining the management of CAD, while also acknowledging current limitations, including image quality requirements, cost, and access.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 8","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12386757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955480","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":"Nuclear Lactate Dehydrogenase A Resists Cardiomyocyte Cell Cycle Arrest Induced by Oxidative Stress.","authors":"Mengfei Cao, Jie Luo, Kewei Fu, Yao Xu, Yinyu Wang, Junying Duan, Rui Chen, Wei Yuan","doi":"10.3390/jcdd12070278","DOIUrl":"10.3390/jcdd12070278","url":null,"abstract":"<p><p>A sudden increase in ambient oxygen concentration after birth forces the metabolic switch from anaerobic glycolysis to oxidative phosphorylation, which contributes to the rapid decline of cardiomyocyte proliferation. Lactate dehydrogenase A (LDHA), a metabolic enzyme normally localized in the cytoplasm, has been reported to regulate cardiomyocyte proliferation via inducing metabolic reprogramming. Nuclear LDHA has been observed in multiple proliferative cells, whereas the role of LDHA nuclear translocation in cardiomyocyte proliferation remains unresolved. Here we found that the expression of nuclear LDHA was induced both in the infarct area of myocardial infarction (MI) in mice and hypoxic cardiomyocytes in vitro. Mechanically, mild hypoxia prompted metabolic reprogramming which motivated cardiomyocyte proliferation by alleviating reactive oxygen species (ROS), while severe hypoxia coincided with oxidative stress that induced cardiomyocyte cell cycle arrest. Interestingly, LDHA nuclear translocation in cardiomyocytes occurred in response to oxidative stress, and blocking of nuclear LDHA resulted in elevated ROS generation. Collectively, our findings uncover a non-canonical role of nuclear LDHA in maintaining redox balance and resisting cardiomyocyte cell cycle arrest.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 7","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12295892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707611","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":"Smaller Bioprosthetic Valves May Be Associated with Worse Clinical Outcomes and Reduced Freedom from Reoperation in sAVR.","authors":"Oliver Lee, David Derish, Dominique Shum-Tim","doi":"10.3390/jcdd12070277","DOIUrl":"10.3390/jcdd12070277","url":null,"abstract":"<p><strong>Background: </strong>Surgical bioprosthetic aortic valve replacement is a ubiquitous procedure, with several factors identified in affecting outcomes. We hypothesize that smaller valves may be associated with worse outcomes and decreased freedom from clinical events, and a shift in implanting larger valves whenever possible may confer benefit to the patient.</p><p><strong>Methods: </strong>A narrative review of the literature was conducted using a systematic search strategy to evaluate studies examining the relationship between bioprosthetic valve size and outcomes. Inclusion criteria focused on studies reporting paired data on valve size and clinical endpoints in surgical AVR.</p><p><strong>Results: </strong>Among the 15 reviewed studies, smaller valve sizes were consistently associated with higher post-operative transvalvular gradients (6/7 studies) and increased reintervention rates (5/8 studies). Associations with accelerated structural valve degeneration (SVD) (3/5 studies) and reduced survival (8/11 studies) were also observed, although heterogeneity in study design and follow-up durations limited definitive conclusions.</p><p><strong>Conclusion: </strong>Our findings suggest that larger valve sizes may improve freedom from SVD, reduce reintervention rates, and enhanced survival. This may also justify the slight increased risk of enlarging the aortic root to accommodate a larger bioprosthetic valve prosthesis. Further high-quality, controlled studies are needed to clarify the independent impact of valve size on long-term outcomes and guide surgical decision-making.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 7","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12295357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707619","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":"Mid-Term Recovery of Right Ventricular Function and Improvement of Left Ventricular Function After Da Silva Cone Procedure for Ebstein Anomaly.","authors":"Krithika Sundaram, Veenah Stoll, Luciana Da Fonseca Da Silva, Adam Christopher, Arvind Hoskoppal, Jacqueline Kreutzer, David Liddle, Laura Olivieri, Jacqueline Weinberg, Craig P Dobson, José P Da Silva, Tarek Alsaied","doi":"10.3390/jcdd12070276","DOIUrl":"10.3390/jcdd12070276","url":null,"abstract":"<p><strong>Background: </strong>The Da Silva Cone procedure for Ebstein anomaly has dramatically improved tricuspid valve competence and clinical outcomes. However, preoperative left ventricular (LV) dysfunction and immediate postoperative right ventricular (RV) systolic dysfunction are frequently observed. While excellent valve outcomes are well established, recovery of biventricular function following the Cone remains less defined. This study aimed to evaluate longitudinal changes in RV and LV function postoperatively and over a minimum of six months post-Cone operation.</p><p><strong>Methods: </strong>A single center retrospective review of 134 patients who underwent Cone repair for Ebstein's anomaly from 2016 to 2024 was performed. Echocardiograms were analyzed at three time points: preoperative (Time 1), hospital discharge (Time 2), and ≥6 months postoperative (Time 3). RV parameters included fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), and tricuspid S'. LV parameters included left ventricular ejection fraction (LVEF), end-diastolic volume indexed to body surface area (LVEDVi), left ventricular stroke volume (LVSVi), and mitral E/E'. Subgroup analyses examined outcomes by prior Glenn, Starnes procedure, and degree of RV dilation. Paired two sample <i>t</i>-tests were used to compare serial measures.</p><p><strong>Results: </strong>Median age at surgery was 7.8 years (IQR: 2.3-17.7). All patients had discharge echocardiograms; 70 had follow-up studies at ≥6 months. RV function declined postoperatively with reductions in FAC (35% to 21%), TAPSE (2.0 to 0.8 cm), and S' (13 to 5 cm/s), all <i>p</i> < 0.001. By Time 3, these measures improved (FAC to 29%, TAPSE to 1.3 cm, S' to 7 cm/s) but did not fully return to baseline. LVEDVi and LVSVi increased significantly by Time 3 (LVEDVi: 47 to 54 mL/m²; LVSVi: 30 to 34 mL/m²; <i>p</i> < 0.001), while LVEF remained unchanged. Patients with prior Glenn or Starnes had greater Time 1 LV volumes and lower RV function, but by Time 3, most differences resolved. Moderate-severe preoperative RV dilation was associated with worse RV function at Time 2 and normalized by Time 3.</p><p><strong>Conclusions: </strong>The Da Silva Cone procedure leads to early postoperative RV dysfunction with partial recovery over the mid-term follow-up. Concurrently, LV filling and stroke volume improve, reflecting favorable interventricular interaction. These findings support echocardiographic surveillance to guide functional recovery post-Cone and inform patient counseling.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 7","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12295748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707609","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":"Left Ventricular Ring-like Pattern: The Arrhythmic Tale of a Scarred Heart.","authors":"Vanda Parisi, Claudio Bergami, Ferdinando Pasquale, Maria Alessandra Schiavo, Irene Ruotolo, Naomi Fanciullo, Nicolò Sini, Matteo Ziacchi, Mauro Biffi, Raffaello Ditaranto, Maddalena Graziosi, Elena Biagini","doi":"10.3390/jcdd12070275","DOIUrl":"10.3390/jcdd12070275","url":null,"abstract":"<p><p>Cardiac magnetic resonance (CMR) imaging provides significant advantages in the non-invasive diagnosis of cardiac diseases. An emerging phenotype is increasingly being described in CMR reports, the LGE \"ring-like\" pattern, which resembles a circumferential/semi-circumferential LV scar. Different conditions exhibit this fibrosis distribution, the majority of them being genetically determined and mostly involving cardiomyopathy-causative genes (desmosomal but also other non-desmosomal related genes). Furthermore, inflammatory diseases, such as myocarditis or sarcoidosis, could be responsible for LV fibrosis, potentially exhibiting an RL distribution. Given the heterogeneity of such conditions, effective patient management requires a stepwise and multiparametric diagnostic work-up that integrates clinical, instrumental, and genetic data to identify the specific aetiology and guide personalised treatments.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 7","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12294988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707606","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":"Plasma Soluble ST2 as a Prognostic Biomarker for Cardiovascular Events and Mortality in COVID-19 Patients.","authors":"Yongcui Yan, Yan Zhuang, Huihui Li, Dao Wen Wang","doi":"10.3390/jcdd12070273","DOIUrl":"10.3390/jcdd12070273","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) is frequently complicated by cardiovascular involvement. Soluble growth stimulation-expressed gene 2 (sST2) is a promising cardiovascular biomarker, but its prognostic value in COVID-19 remains unclear.</p><p><strong>Methods: </strong>This retrospective cohort study included 314 hospitalized COVID-19 patients classified into mild/moderate (<i>n</i> = 168) and severe/critical (<i>n</i> = 146). Plasma sST2 were measured using an enzyme-linked immunosorbent assay. Correlation analyses evaluated associations between sST2 and clinical parameters. Cox regression assessed the independent predictive value for cardiovascular events and all-cause mortality.</p><p><strong>Results: </strong>sST2 levels were significantly higher in severe/critical patients (16.877 ng/mL) than in mild/moderate cases (6.189 ng/mL) and healthy controls (4.003 ng/mL). sST2 positively correlated with cardiac injury markers (cTnI, CK-Mb, NT-proBNP), inflammatory indices (IL-1β, hsCRP), D-dimer, and inversely correlated with a left ventricular ejection fraction (r = -0.86). Elevated sST2 independently predicted cardiovascular events (HR = 2.972) and mortality (HR = 4.681). The Kaplan-Meier survival analysis demonstrated higher cardiovascular event rates and lower survival probabilities in patients with elevated sST2. The ROC curve indicated sST2 outperformed cTnI and NT-proBNP in predicting cardiovascular events (AUC = 0.898) and mortality (AUC = 0.871).</p><p><strong>Conclusion: </strong>Elevated sST2 is associated with myocardial injury, inflammation, and poor prognosis in COVID-19, supporting its value for risk stratification.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 7","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12295835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707614","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}