Zhiyuan Ma, Mahesh Krishnamurthy, Vikas Yellapu, Eluwana Amaratunga, Peter Puleo, David Allen, Jamshid Shirani
{"title":"Impact of congestive Heart failure on early fluid administration and mortality in patients with Sepsis.","authors":"Zhiyuan Ma, Mahesh Krishnamurthy, Vikas Yellapu, Eluwana Amaratunga, Peter Puleo, David Allen, Jamshid Shirani","doi":"10.1016/j.jjcc.2025.07.001","DOIUrl":"https://doi.org/10.1016/j.jjcc.2025.07.001","url":null,"abstract":"<p><strong>Background: </strong>Congestive heart failure (CHF) may increase the risk of volume overload and mortality in patients with sepsis, potentially complicating fluid resuscitation-a cornerstone of sepsis management. We aimed to assess whether pre-existing CHF is associated with excess mortality and different fluid administration patterns in intensive care unit patients with sepsis.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the MIMIC-IV database of critically ill adults with sepsis. Multivariable logistic regression and propensity score matching were used to compare in-hospital mortality and fluid resuscitation between patients with and without CHF. Generalized additive models assessed the relationship between fluid volume and mortality.</p><p><strong>Results: </strong>Among 24,376 patients with sepsis, 6838 (28.1 %) had CHF. CHF was associated with higher in-hospital mortality (14.3 % vs. 9.8 %, p < 0.001) and lower 24-h fluid volume (median 1936 mL vs. 3037 mL, p < 0.001). Adjusted odds of mortality were higher in CHF patients (OR 1.25, 95 % CI 1.14-1.37; p < 0.001). A U-shaped association between fluid volume and mortality was observed in non-CHF patients, with the lowest mortality at ~60 mL/kg. In CHF patients, high fluid administration did not improve survival, while restrictive strategies increased mortality.</p><p><strong>Conclusions: </strong>Pre-existing CHF is linked to higher mortality in sepsis. Adequate fluid administration improved mortality in those without CHF, while in CHF patients, neither liberal nor restrictive fluid administration showed a clear mortality benefit.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Association between partial smoking ban legislation and acute coronary syndrome: A Nationwide analysis.","authors":"Michikazu Nakai, Yoshitaka Iwanaga, Hisayoshi Fujiwara","doi":"10.1016/j.jjcc.2025.06.023","DOIUrl":"https://doi.org/10.1016/j.jjcc.2025.06.023","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Valve in valve transcatheter versus redo surgical replacement of a failing surgical bioprosthetic aortic valve: An updated systematic review and meta-analysis.","authors":"Kyriakos Dimitriadis, Nikolaos Pyrpyris, Konstantinos Aznaouridis, Stergios Soulaidopoulos, Georgios Koutsopoulos, Eirini Beneki, Fotis Tatakis, Eleni Adamopoulou, Panagiotis Tsioufis, Chiara DeBiase, Dejan Milasinovic, Ole De Backer, Maarten Vanhaverbeke, Konstantina Aggeli, Konstantinos Tsioufis","doi":"10.1016/j.jjcc.2025.06.022","DOIUrl":"10.1016/j.jjcc.2025.06.022","url":null,"abstract":"<p><strong>Background: </strong>With the aging population, degeneration of surgical aortic valves is an important clinical scenario. Currently, in most European countries, both redo surgery [redo-surgical aortic valve replacement (SAVR)] and valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) are established alternatives for treating such patients. This meta-analysis aims to compare redo-SAVR and ViV-TAVI for treating a failing bioprosthetic aortic valve.</p><p><strong>Methods: </strong>A systematic search was performed from inception to June 2023. After selecting all appropriate trials according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a random effect meta-analysis was performed. Clinical and echocardiographic outcomes were compared among the groups.</p><p><strong>Results: </strong>Twenty-six studies with a total of population of 17,581 patients were included [ViV-TAVI (n = 9163) or redo-SAVR (n = 8418]. ViV-TAVI was associated with lower 30-day mortality (RR: 0.55; 95%CI: 0,47 to 0,66) and 1-year mortality (RR: 0.85; 95%CI: 0.75 to 0.96), major bleeding events (RR: 0.58; 95%CI: 0.42-0.79), and a trend towards lower new pacemaker implantations (RR: 0.70; 95%CI: 0.49-1.01) at 30 days. On the other hand, ViV-TAVI resulted in a higher mean transprosthetic gradient and higher rates of severe patient-prosthesis mismatch (RR: 1.64; 95%CI: 1.01 to 2.65) and paravalvular leak (RR: 2.44; 95%CI: 1.73-3.45) as compared to redo-SAVR. No significant difference was observed in 30-day myocardial infarction (RR: 0.90; 95%CI: 0.56 to 1.46) or stroke (RR: 0.77; 95%CI:0.55 to 1.06).</p><p><strong>Conclusion: </strong>ViV-TAVI has a satisfying safety profile with better short-term survival outcomes as compared to redo-SAVR. However, adequate pre-procedural planning of VIV-TAVI cases is needed, in order to minimize the risk of a suboptimal hemodynamic outcomes following ViV-TAVI.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Osteoporosis and risk of aortic stenosis in Japanese elderly: A population-based nested case-control study.","authors":"Takuya Uematsu, Yusuke Hirabuki, Shuko Nojiri, Yuji Nishizaki","doi":"10.1016/j.jjcc.2025.06.019","DOIUrl":"10.1016/j.jjcc.2025.06.019","url":null,"abstract":"<p><strong>Background: </strong>Aortic stenosis (AS), a common condition among older adults, is caused by aging and calcium metabolism, and its association with osteoporosis has garnered attention. However, the relationship between AS and osteoporosis has not been consistent across studies in Japan and globally. This study aimed to investigate the association between osteoporosis and AS in the older adult population in Japan.</p><p><strong>Methods: </strong>We conducted a nested case-control study using an administrative database in Japan comprising 1.16 million individuals. Cases and controls were matched 1:1 based on age and sex. A conditional logistic regression model was employed for estimating the adjusted odds ratio of osteoporosis for AS, along with its 95 % confidence interval (CI), after adjusting for covariates.</p><p><strong>Results: </strong>Overall, 8136 cases of AS and 8136 controls aged 65 years were identified. After adjusting for covariates, the odd of exposure to osteoporosis for AS was 0.887 (95 % CI, 0.778-1.01), indicating no significant association between the two conditions. However, significant associations were observed for diabetes mellitus, chronic kidney disease, hypertension, and dyslipidemia. Additionally, the use of diuretics, particularly in the late elderly, was significantly associated with AS.</p><p><strong>Conclusions: </strong>The findings of this study, based on real-world data involving over one million individuals, revealed no association between AS and osteoporosis. Future research should further clarify the impact of diuretics on AS and perform a comprehensive analysis considering other factors related to the relationship between AS and osteoporosis.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diuretic resistance measured by sodium excretion and urine output in acute heart failure: The DIURESIS-AHF study.","authors":"Yudai Fujimoto, Takeshi Kitai, Takahito Nasu, Shingo Matsumoto, Yoshihisa Naruse, Hirofumi Hioki, Masato Shimizu, Taishi Yonetsu, Yu Horiuchi, Yuya Matsue","doi":"10.1016/j.jjcc.2025.06.018","DOIUrl":"10.1016/j.jjcc.2025.06.018","url":null,"abstract":"<p><strong>Background: </strong>The dynamics and prognostic value of diuretic metrics in response to initial intravenous (IV) diuretic therapy in patients with acute heart failure (AHF) remain unclear. We assessed the association between urinary sodium concentration, diuretic response (DR) following IV furosemide administration, and their prognostic implications in patients with AHF.</p><p><strong>Methods: </strong>The diuretic resistance measured by sodium excretion and urine output (DIURESIS)-AHF study was a prospective, multicenter, observational study that assessed spot urinary sodium concentrations at 0/1/2 h, total urine output, and urinary sodium excretion achieved within the first 6 h following initial IV furosemide administration. The DR was measured using the urine output or sodium excretion per 40 mg of IV furosemide.</p><p><strong>Results: </strong>Ninety-six patients with AHF (mean age, 78 years; men, 56 %) were included. Urine sodium concentrations at 1/2 h showed high inter- and intra-patient variabilities. A lower DR based on 6-h sodium excretion was independently associated with a higher incidence of composite outcome, even after adjusting for known risk factors (/10-mmol increase; hazard ratio: 0.96, 95 % confidence interval: 0.93-0.99, p = 0.011); the DR measured by urine output was not.</p><p><strong>Conclusions: </strong>Urine sodium concentrations at 1/2 h after initial IV furosemide showed great inter- and intra-patient variabilities, and lower DR using 6-h sodium excretion after IV furosemide was associated with a poor prognosis in patients with AHF.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How to demonstrate the causal relationship between sodium-glucose cotransporter 2 receptor and prevention of ventricular arrhythmia in heart failure cohorts","authors":"Naoya Kataoka MD, Teruhiko Imamura MD, PhD, FJCC","doi":"10.1016/j.jjcc.2025.01.006","DOIUrl":"10.1016/j.jjcc.2025.01.006","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"86 1","pages":"Page 103"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}