Journal of Cardiothoracic Surgery最新文献

{"title":"Value of serum LncRNA KIF9-AS1 combined with CT signs in the diagnosis of benign and malignant early pulmonary nodules and its correlation with prognosis.","authors":"Huichao Wu, Jian Liu, Zhongjun Jing, Zihua Qi, Xianjun Ma, Junying Zhao, Laichong Huang","doi":"10.1186/s13019-025-03438-2","DOIUrl":"https://doi.org/10.1186/s13019-025-03438-2","url":null,"abstract":"<p><strong>Background: </strong>Early screening for lung cancer and early treatment of malignant pulmonary nodules (PNs) contribute a lot to reducing lung cancer mortality. Whether the highly expressed lncRNA KIF9-AS1 in multiple malignancies is associated with the development of malignant PNs is not clear. This study focused on the diagnosis and prognosis value of KIF9-AS1 in PNs patients.</p><p><strong>Methods: </strong>The study population included 101 individuals with benign PNs and 172 patients diagnosed with malignant PNs. The expression of KIF9-AS1 was analyzed by qRT-PCR. The receiver operator characteristic (ROC) curve was plotted to evaluate the diagnostic performance while the Kaplan-Meier curve and multivariate Cox regression analysis were employed for prognosis. Correlation assessment was accomplished by Pearson correlation analysis.</p><p><strong>Results: </strong>Differentiated expression of KIF9-AS1 was found in benign and malignant PNs groups. The expression of KIF9-AS1 was positively associated with carcinoembryonic antigen (CEA) and cytokeratin 19 fragments 21 - 1 (CYFRA21-1). KIF9-AS1 presented high accuracy in distinguishing malignant PNs from benign PNs, especially combined with computed tomography (CT). The expression level of KIF9-AS1, and nodule diameter were independent risk factors of poor prognosis.</p><p><strong>Conclusions: </strong>Assessment of serum KIF9-AS1 level contributed to clinical diagnosis and prognosis of malignant PNs and also improved the diagnostic value of CT.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"228"},"PeriodicalIF":1.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019333","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":"Cocultured amniotic stem cells and cardiomyocytes in a 3-D acellular heart patch reduce the infarct size and left ventricle remodeling: promote angiogenesis in a porcine acute myocardial infarction model.","authors":"Muhammad Arza Putra, Normalina Sandora, Tri Wisesa Soetisna, Tyas Rahmah Kusuma, Nur Amalina Fitria, Benati Karimah, Deni Noviana, Gunanti, Pribadi Wiranda Busro, Supomo, Idrus Alwi","doi":"10.1186/s13019-025-03453-3","DOIUrl":"https://doi.org/10.1186/s13019-025-03453-3","url":null,"abstract":"<p><strong>Background: </strong>Acute myocardial infarction (AMI) induces significant myocardial damage, ultimately leading to heart failure as the surrounding healthy myocardial tissue undergoes progressive deterioration due to excessive mechanical stress.</p><p><strong>Methods: </strong>This study aimed to investigate myocardial regeneration in a porcine model of AMI using an acellular amniotic membrane with fibrin-termed an amnion bilayer (AB) or heart patch-as a cellular delivery system using porcine amniotic stem cells (pASCs) and autologous porcine cardiomyocytes (pCardios). Fifteen pigs (aged 2-4 months, weighing 50-60 kg) were randomly assigned to three experimental groups (n = 5): control group (AMI induction only), pASC group (pASC transplantation only), and coculture group (pASC and pCardio transplantation). AMI was induced via posterior left ventricular artery ligation and confirmed through standard biomarkers. After eight weeks, histological and molecular analyses were conducted to assess myocardial regeneration.</p><p><strong>Results: </strong>Improvement in regional wall motion abnormality (RWMA) was observed in 60% of the coculture group, 25% of the pASC group, and none in the control group. Histological analysis of the control group revealed extensive fibrosis with pronounced lipomatosis, particularly at the infarct center. In contrast, pASC and coculture groups exhibited minimal fibrotic scarring at both the infarct center and border regions. Immunofluorescence analysis demonstrated positive α-actinin expression in both the pASC and coculture groups, with the coculture group displaying sarcomeric structures-an organization absent in control group. RNA expression levels of key cardiomyogenic markers, including cardiac troponin T (cTnT), myosin heavy chain (MHC), and Nkx2.5, were significantly elevated in the treatment groups compared to the controls, with the coculture group exhibiting the highest MHC expression. The expression of c-Kit was also increased in both treatment groups relative to the control. Conversely, apoptotic markers p21 and Caspase-9 were highest in the control group, while coculture group exhibited the lowest p53 expression.</p><p><strong>Conclusion: </strong>Epicardial transplantation of an acellular amniotic heart patch cocultured with cardiomyocytes and pASCs demonstrated superior cardiomyogenesis after eight weeks compared to pASC transplantation alone or control conditions. The coculture system was found to enhance the cardiac regeneration process, as evidenced by improved RWMA, distinct sarcomeric organization, reduced fibrotic scarring, and lower apoptotic gene expression.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"229"},"PeriodicalIF":1.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997965","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":"Presentation of a residual post-myocardial infarction ventricular septal defect; a literature review based on a case report.","authors":"Mehrdad Jafari, Mohammad Khani, Tooba Akbari, Elham Farahani, Fariba Bayat, Abdulhamid Bagheri, Amir Nasrollahizadeh, Pedram Ramezani, Pouya Ebrahimi, Mohammad Hossein Mandegar","doi":"10.1186/s13019-025-03440-8","DOIUrl":"https://doi.org/10.1186/s13019-025-03440-8","url":null,"abstract":"<p><strong>Introduction: </strong>In the era of modern techniques for the early diagnosis and revascularization of myocardial infarction, post-myocardial infarction ventricular septal defect is rarely seen. However, this potentially fatal complication of ischemic cardiac events cannot always be detected and diagnosed in a straightforward pattern of practice. This study presents an initially delayed-presented post-infarction ventricular septal defect.</p><p><strong>Case presentation: </strong>The patient was a 58-year-old white man who presented to the cardiology clinic complaining of moderate exertional dyspnea initiated two months ago and exacerbated by the time. His medical history includes an admission three years prior, where he was diagnosed with COVID-19 pneumonia and a myocardial infarction that was complicated by a ventricular septal defect (VSD) and hemodynamic instability. This condition was managed through urgent surgical revascularization and closure of the defect. Due to his current symptoms, further cardiac investigations were planned. A transthoracic echocardiogram was recommended after detecting a grade 3/6 systolic murmur during the physical examination. The initial assessment using an apical four-chamber TTE appeared normal. However, when performing a modified view with a posterior tilt, a bulging septum was observed, leaning toward the right ventricle. This bulging contained a defect with a left-to-right shunt, identified as a residual defect in the area of the repaired patch, along with a myocardial aneurysm. Due to the inconsequential findings from the echocardiogram study, the patient was scheduled for a follow-up echocardiogram, which showed no changes after six months. Additionally, the patient underwent therapeutic management addressing chronic obstructive pulmonary disease.</p><p><strong>Conclusion: </strong>Although post-infarction ventricular septal defects are rarely seen in the revascularization era, the COVID-19 era was associated with an increase in the prevalence of this complication. It is important to be vigilant for patients who experienced an index event during that time. This potentially fatal complication can present with new issues following the initial event, such as residual defects. Comprehensive imaging studies are necessary to detect the underlying pathology.</p><p><strong>Key clinical message: </strong>Diagnosing post-infarction ventricular septal defect requires the hypervigilance and precision of the cardiologist, who examines the patient and performs the cardiac imaging. Therefore, comprehensive investigations are crucial in patients with a suspicious history of ischemic cardiac events.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"230"},"PeriodicalIF":1.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965684","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":"The association of pulmonary artery catheterization utilization and surgical patients' outcomes: a PRISMA-compliant systematic review and meta-analysis.","authors":"Chun-Mei Xie, Li-Xian He, Meng-Qi Shen, Yun-Tai Yao","doi":"10.1186/s13019-025-03416-8","DOIUrl":"https://doi.org/10.1186/s13019-025-03416-8","url":null,"abstract":"<p><strong>Background: </strong>The utilization of pulmonary artery catheterization (PAC) in surgical patients remains controversial. This study aims to assess the impact of PAC utilization on surgical patient outcomes.</p><p><strong>Methods: </strong>Electronic databases were searched for studies comparing PAC with no-PAC in surgical patients. The primary outcome was short-term mortality. Secondary outcomes included the incidence of postoperative complications, postoperative recovery indicators, and hospitalization costs.</p><p><strong>Results: </strong>Ten randomized controlled trials (n = 2,889) and sixteen observational studies (n = 2,221,917) were included. Among these studies, fifteen involved cardiac surgical patients (n = 2,217,736), and eleven involved non-cardiac surgical patients (n = 7,070). The present study demonstrated PAC utilization did not affect short-term mortality in cardiac surgical patients [odds ratio (OR) 1.20, 95% confidence interval (CI) 0.79-1.82, p 0.40], and was associated with a higher incidence of postoperative chronic heart failure, acute renal failure, cerebrovascular events, infectious complications, and longer length of stay (LOS) in intensive care unit (ICU) or hospital. Moreover, PAC utilization was not associated with short-term mortality (OR 0.40, 95% CI 0.16-1.02, p 0.06) and other outcomes for non-cardiac surgical patients.</p><p><strong>Conclusions: </strong>This meta-analysis suggested PAC utilization was not associated with short-term mortality in surgical patients but with a higher incidence of major complications and longer LOS in the ICU or hospital in cardiac surgical patients.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"227"},"PeriodicalIF":1.5,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036520","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":"Effectiveness and safety of different types of ablation modalities in patients with atrial fibrillation: a bayesian network meta-analysis from randomized controlled trials.","authors":"Fan Maitri Aldian, Visuddho Visuddho, Bendix Samarta Witarto, Andro Pramana Witarto, Jason Oktavian Hartanto, Yan Efrata Sembiring, Jeswant Dillon","doi":"10.1186/s13019-025-03460-4","DOIUrl":"https://doi.org/10.1186/s13019-025-03460-4","url":null,"abstract":"<p><strong>Introduction: </strong>Atrial fibrillation (AF) is the most common cardiac arrhythmia, which significantly contributes to morbidity, mortality, and a diminished quality of life. Despite advancements in pharmacological treatments, many AF patients do not achieve adequate symptom control with oral medications. This network meta-analysis seeks to provide comprehensive evidence to guide clinical decision-making and optimize ablation strategies for patients with atrial fibrillation.</p><p><strong>Methods: </strong>This network meta-analysis (NMA) was conducted in accordance to PRISMA NMA Checklist of Items (PROSPERO No. CRD42024577782). A comprehensive search was performed across major literature databases (PubMed, Scopus, CENTRAL, ProQuest, and Web of Science) up to July 10, 2024. Data analyses were performed using Rstudio v.4.4.1 employing Bayesian NMA with random-effects models. Sensitivity, subgroup, and network meta-regression analyses were also conducted. SUCRA values were estimated to present the ranking of each treatment in the network. Meta-proportions with GLMM (Generalized Linear Mixed Model) also performed to analyze the safety outcomes.</p><p><strong>Results: </strong>A total of 6332 AF patients from 46 randomized controlled trials (RCTs) were included. NMA demonstrate epicardial (surgical) approach, especially video-assisted thoracoscopic surgery (VATS) (OR 1.54; 95%CrI [1.03,2.38]; SUCRA 89.61) exhibited superiority to reduce the AF recurrence in AF patients. Hybrid epicardial-endocardial ablation (OR 1.51; 95% CrI [0.82,2.82]; SUCRA 85.7) had a similar freedom from AF rate to VATS. Subgroup and network meta-regression analysis revealed that AF type ((β -0.415; [-0.776;-0.042]) and AF duration (β 0.602; [0.066;1.079]) influence the freedom from AF rate. Meta-proportion indicated that surgical or hybrid ablation exhibited a higher risk of mortality (Prop = 5.07%), pericardial effusion (Prop = 4.35%), and phrenic nerve injury (Prop = 4.35%).</p><p><strong>Conclusion: </strong>NMA demonstrated higher effectiveness of VATS and hybrid ablation in reducing the recurrence rate of AF. Despite complications associated with surgical and hybrid approaches have higher prevalence, type of complications encountered in this approaches are less diverse.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"225"},"PeriodicalIF":1.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018848","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":"Circ-PSMB1 knockdown inhibits the pyroptosis of ox-LDL treated human aortic cells via the miR-624-3p/ASC axis.","authors":"Yupu Zhou, Yongchuan Guo","doi":"10.1186/s13019-025-03457-z","DOIUrl":"https://doi.org/10.1186/s13019-025-03457-z","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerosis (AS) is a cardiovascular disease that is caused by a variety of factors, including hypertension, diabetes, hyperlipidaemia and smoking. Circular RNAs (circRNAs) have been reported to participate in the progression of AS. Here, we investigated the mechanism by which circ-proteasome 20 S subunit beta 1 (PSMB1) participates in AS.</p><p><strong>Methods: </strong>HAECs were stimulated with oxidized low-density lipoprotein (ox-LDL) to establish a model of AS in vitro. Cell viability was investigated with MTT assays. Western blotting and qRT‒PCR were used to measure relative protein and mRNA expression. Cell pyroptosis was analysed by flow cytometry. Lactate dehydrogenase (LDH) levels were measured with a commercial kit.</p><p><strong>Results: </strong>We found that circ-PSMB1 and apoptosis-associated speck-like protein containing a CARD (ASC) were overexpressed and miR-624-3p was expressed at low levels in HAECs treated with ox-LDL. Circ-PSMB1 silencing enhanced cell viability and decreased pyroptosis, as shown by the downregulation of IL-1β and IL-18 mRNA expression as well as NOD-like receptor thermal protein domain associated protein 3 (NLRP3) and GasderminD-N (GSDMD-N) protein expression. In addition, the miR-624-3p inhibitor neutralized the effects of si-circ-PSMB1, and ASC overexpression neutralized the effects of the miR-624-3p mimic in ox-LDL-treated HAECs.</p><p><strong>Conclusion: </strong>This research demonstrated that circ-PSMB1 might participate in AS development through regulating the pyroptosis of HAECs via the miR-624-3p/ASC axis.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"226"},"PeriodicalIF":1.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019760","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 psycho-educational interventions on patients undergoing Coronary Artery Bypass Grafting Surgery.","authors":"Shahpar Bagheri, Zahra Dadashpouromrani, Giti Setoodeh, Zahra Hadian Shirazi, Azadeh Amiri, Rozhan Ghobadimoghaddam","doi":"10.1186/s13019-025-03461-3","DOIUrl":"https://doi.org/10.1186/s13019-025-03461-3","url":null,"abstract":"<p><strong>Background: </strong>Postoperative period of Coronary Artery Bypass Grafting can be challenging, with physical and psychological problems and symptoms. We conducted this study to explore the effect of a psycho-educational intervention on anxiety, pain and physiological parameters among Coronary Artery Bypass Grafting surgery patients.</p><p><strong>Methods: </strong>A randomized clinical trial design included one experimental and control group. Data were collected from 56 candidates for coronary artery bypass surgery (n = 28) in the intervention and (n = 28) in the usual care groups. Settings were the cardiac centers of the three teaching, specialty, and subspecialty Nemazee, Faghihi, and Al-Zahra hospitals affiliated with Shiraz University of Medical Sciences (SUMS). The data were collected using a demographic information form, the Short-Form McGill Pain Questionnaire, the Spielberger State-Trait Anxiety Inventory, and the physiological parameters form (systolic and diastolic blood pressure, heart rate, respiratory rate, and peripheral oxygen saturation). Psycho-educational interventions were performed individually through face-to-face sessions. All tests were two-tailed, and the statistical level was considered 0.05.</p><p><strong>Results: </strong>The mean scores of state anxiety and pain decreased significantly after the intervention (p < 0.05). Also, psycho-educational interventions affected peripheral oxygen saturation percentage, and breathing rate mean scores (P < 0.05). But, they did not affect the blood pressure and pulse rate (P > 0.05). At the same time, there was no significant difference in the control group.</p><p><strong>Conclusion: </strong>This study indicated that the pre-operative psycho-educational interventions facilitated intrapersonal caring, reduce state anxiety, relieve pain and stabilize physiological parameters such as peripheral oxygen saturation percentage and breathing rate after surgery among Coronary Artery Bypass Grafting surgery patients. Hence, this intervention is recommended for developing care programs in same population.</p><p><strong>Trial registration: </strong>https://www.irct.ir/trial/55652 : IRCT20090908002432N8 (2021-09-17).</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"223"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019766","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":"Analysis of serum levels of HIF-1α and IL-6 in patients with acute stanford type a aortic dissection.","authors":"Zheyuan Wang, Junyi Wen, Shaoqin Chen, Lin Lu","doi":"10.1186/s13019-025-03459-x","DOIUrl":"https://doi.org/10.1186/s13019-025-03459-x","url":null,"abstract":"<p><strong>Background: </strong>Studies have reported that Acute Stanford type A aortic dissection (ATAAD) is associated with hypoxia and inflammation. This study aims to explore the levels of HIF-1α and IL-6 in the serum of patients with ATAAD, and to analyze the association between these two factors as well as their potential clinical significance.</p><p><strong>Methods: </strong>Serum samples were collected from 82 ATAAD patients and 19 healthy controls. Subsequently, the levels of HIF-1α and IL-6 in the serum of these samples were measured using the enzyme-linked immunosorbent assay (ELISA).</p><p><strong>Results: </strong>The results showed that the serum HIF-1α level in patients with ATAAD were significantly reduced compared with the healthy control group [10.72 (7.28,14.92) vs. 19.54 ± 8.07 pg/mL, p < 0.0001], and the serum IL-6 level were significantly increased [3.12 (1.97, 9.13) vs. 1.13 (0.98, 1.42) pg/mL, p < 0.0001]. Moreover, there was no statistical difference of HIF-1α level in ATAAD patients with or without hypoxemia and IL-6. However, there was a significant positive correlation between the levels of IL-6 and the expression of HIF-1α (r = 0.5435, P < 0.0001).</p><p><strong>Conclusion: </strong>We found that levels of HIF-1α and IL-6 were abnormal in patients with ATAAD. Moreover, the HIF-1α and IL-6 level in ATAAD patients were positively correlated, suggesting that HIF-1α and IL-6 may play roles simultaneously during the development of acute aortic dissection.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"222"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992559","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":"Meta-analysis of targeted drugs for pulmonary hypertension to improve exercise tolerance and associated factors in eisenmenger syndrome.","authors":"Zhangli Yuan, Yang Wang, Jianling Wang, Yinchuan Lai, Xuechuan Dan, Juan Wang","doi":"10.1186/s13019-025-03450-6","DOIUrl":"https://doi.org/10.1186/s13019-025-03450-6","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to systematically evaluate the effect of pulmonary arterial hypertension (PAH) targeting drugs on exercise tolerance in Eisenmenger syndrome (ES) and analyze related factors.</p><p><strong>Methods: </strong>Two researchers conducted an independent search of the Chinese database and the English database, and conducted literature screening, data extraction and quality evaluation according to the inclusion and exclusion criteria respectively. According to the heterogeneity test results, the effect model was adopted for analysis by RevMan5.4 statistical software, in which the continuity data were represented by mean difference (MD) and 95% confidence interval (CI).</p><p><strong>Results: </strong>A total of 393 patients with ES were included in 13 papers, including 8 studies of endothelin receptor antagonists (ERA), 2 studies of phosphodiesterase 5 inhibitors (PDE5i) and 3 studies of prostanoids. The results of these studies showed that the targeted drugs were effective in improving exercise tolerance in ES patients. Further analyses revealed that the differences in efficacy were related to the type of targeted drug, duration of drug treatment and the presence or absence of Down syndrome (DS). 6MWD (6 min Walk Distance) and cardiac function were significantly improved in ES patients with all three classes of drugs. Prostanoids (MD = 132.35, 95% CI: 14.82-249.89, P < 0.0001, I² = 93%) improved 6MWD better than ERAs (MD = 41.60, 95% CI: 21.76-61.44, P < 0.0001, I² = 32%) and PDE5i (MD = 52.33, 95% CI: 29.16-75.50, P < 0.0001, I² = 0). Prostanoids demonstrated a more significant improvement in cardiac function compared to ERAs and PDE5i. Specifically, prostanoids [MD= -1.26, 95% CI: (-1.66, -0.86), P < 0.0001] showed a greater improvement than ERAs [MD=-0.54, 95% CI: (-0.96, -0.11), P = 0.01] and PDE5i [MD=-0.38, 95% CI: (-0.64, -0.13), P = 0.003]. Short-term pharmacological therapy (less than 12 months) significantly increased 6MWD and improved clinical cardiac function in included patients. Continued targeted drug therapy further increased the level of cardiac function (P < 0.0001). Targeted drug therapy was effective in increasing 6MWD in patients with ES combined with DS, but had no significant effect on cardiac function class. Targeted drug therapy had a favorable effect on both 6MWD and cardiac function class in non-DS patients.</p><p><strong>Conclusion: </strong>Early targeted drug therapy for ES can significantly improve the exercise tolerance of patients, and a better drug regimen and treatment time should be selected according to the clinical characteristics of patients.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"224"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016524","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":"The application of the triglyceride-glucose-body mass index (TyG-BMI) in predicting acute kidney injury in diabetic patients following coronary artery bypass grafting surgery.","authors":"Chen Li, Xiaobin Liu, Xingping Lv, Wei Zhou, Guoliang Fan, Feng Zhu","doi":"10.1186/s13019-025-03455-1","DOIUrl":"https://doi.org/10.1186/s13019-025-03455-1","url":null,"abstract":"<p><strong>Background: </strong>The triglyceride-glucose-body mass index (TyG-BMI), a marker for insulin resistance, is recognized for its predictive role in cardiovascular and metabolic diseases, including kidney disease. we explored the TyG-BMI index's association with postoperative kidney injury in coronary artery bypass grafting (CABG) patients, who are at an elevated risk for such complications, underscoring its potential as a predictor for acute kidney injury (AKI).</p><p><strong>Methods: </strong>This single-center, retrospective study included 126 patients. Patients were divided into AKI and non-AKI groups postoperatively according to the KDIGO classification criteria. Univariate logistic regression was used to screen for variables with significant differences (P < 0.01), and multiple multivariate regression models were constructed to analyze independent risk factors in the multivariate regression model and to analyze the value of TyG-BMI in predicting AKI in diabetic patients after CABG.</p><p><strong>Results: </strong>Compared to the non-AKI group, the AKI group had statistically significant differences in preoperative fasting triglycerides, preoperative fasting glucose, preoperative and postoperative creatinine levels, ICU stay duration, and TyG-BMI levels (P < 0.05). Based on the results of univariate regression analysis, a multivariate logistic regression model A was constructed using all significant variables, and a multivariate logistic regression model 2 was constructed using significant variables other than TyG-BMI. ROC analysis showed that model 2 had better predictive performance than model 1 (AUC = 0.836 vs. 0.766). A positive correlation was observed between TyG-BMI and AKI occurrence (Spearman's correlation coefficient: R = 0.33, P = 0.00019).</p><p><strong>Conclusion: </strong>Elevated TyG-BMI levels are closely associated with AKI in diabetic patients after CABG. TyG-BMI has potentially predictive value for AKI in diabetic patients after CABG and may play a crucial role in risk stratification in clinical practice.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"221"},"PeriodicalIF":1.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018853","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}