{"title":"Antithrombotic management in catheter ablation for ventricular arrhythmias - Mini review.","authors":"Kanae Hasegawa, William G Stevenson","doi":"10.1016/j.jjcc.2025.08.006","DOIUrl":"10.1016/j.jjcc.2025.08.006","url":null,"abstract":"<p><p>Radiofrequency catheter ablation (RFCA) is a common treatment option for ventricular arrhythmias (VA). Risks of RFA for VA include emboli and bleeding complications. In contrast to atrial fibrillation ablation procedures, for which anticoagulation therapy is relatively well standardized, peri-procedural antithrombotic therapy practices for RFCA of VA vary among laboratories and remains an area of investigation. This summary focuses on the current evidence-based antithrombotic therapies of RFCA for VA, with a particular emphasis on two recent major studies.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955678","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":"First trimester metabolic syndrome insulin resistance index and offspring congenital heart disease risk: The mediating role of gestational diabetes mellitus.","authors":"Junwei Liu, Yibing Zhu, Huimin Shi, Yecheng Miao, Jiayi Chen, QingXiu Li, Bin Sun, Danwei Zhang, Zhengqin Wu, Haiyan Gao, Wei Li, Wenjuan Liu, Qian Zhang, Haibo Li","doi":"10.1016/j.jjcc.2025.08.008","DOIUrl":"https://doi.org/10.1016/j.jjcc.2025.08.008","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this research was to investigate the association between the first trimester metabolic score for insulin resistance (METS-IR) index and offspring congenital heart disease (CHD), and to pay special attention to the mediating role of gestational diabetes mellitus (GDM).</p><p><strong>Methods: </strong>A total of 21,401 women without pre-existing diabetes were enrolled in a prospective birth cohort study conducted in China. The participants were categorized into four groups based on their METS-IR index scores. Multivariate logistic regression models were used to assess the association between the first trimester METS-IR and CHD in their offspring. Mediation analysis was conducted to determine if GDM mediates this association.</p><p><strong>Results: </strong>The increase in the METS-IR index in the first trimester was positively correlated with a significantly increased risk of CHD in offspring. Compared with the low METS-IR level group, the CHD risk in the high METS-IR group increased by 40 %. There was a positive linear dose-response relationship between METS-IR and CHD risk. Joint exposure to GDM and an elevated first-trimester METS-IR index significantly increased the risk of CHD in offspring, with evidence of a synergistic interaction on both multiplicative and additive scales. The estimated mediation proportion was 20.15 %.</p><p><strong>Conclusions: </strong>The first-trimester METS-IR index was associated with an increased risk of CHD, and GDM partially mediated the association between the METS-IR index in the first trimester and CHD.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955681","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":"Mechanism of mitral valve tethering caused by apical sparing contractility pattern in transthyretin amyloid cardiomyopathy.","authors":"Keitaro Shinada, Jin Endo, Hikaru Tsuruta, Akito Matsumura, Kohsuke Shirakawa, Marina Okada, Hidehiko Ikura, Hiroki Kitakata, Hidenori Moriyama, Masaki Ieda","doi":"10.1016/j.jjcc.2025.08.005","DOIUrl":"10.1016/j.jjcc.2025.08.005","url":null,"abstract":"<p><strong>Background: </strong>In transthyretin amyloid cardiomyopathy (ATTR-CM), pathological changes occur in the mitral valve, but the mechanism remains largely unknown. This study aimed to clarify the mechanism through quantitative analysis of the morphology and function of the mitral valve using three-dimensional (3D) echocardiography.</p><p><strong>Methods: </strong>A total of 69 patients with ATTR-CM who underwent 3D transthoracic echocardiography from December 2015 to October 2022 were compared with 30 healthy controls.</p><p><strong>Results: </strong>3D echocardiographic analysis revealed increased mitral annular dilation and mitral valve tethering in patients with ATTR-CM. In the preserved left ventricular ejection fraction (ATTR-pEF) subgroup (n = 36), mitral valve tethering was more pronounced, despite normal mitral annular area. The rate of change in the distance between mitral annulus and papillary muscle was significantly higher in ATTR-CM patients and was an independent predictor of mitral valve tethering in the ATTR-pEF group. Among indices of left ventricular function, only the apical sparing ratio was correlated with this change ratio in the multivariate analysis.</p><p><strong>Conclusion: </strong>Mitral valve tethering is observed in ATTR-CM regardless of EF. Apical sparing at systole increases in the mitral annulus-papillary muscle distance, leading to mitral valve tethering.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873367","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":"Early door-to-unloading and in-hospital mortality in patients with non-acute coronary syndrome cardiogenic shock undergoing Impella introduction.","authors":"Taikan Terauchi, Masayoshi Yamamoto, Daigo Hiraya, Yoshitaka Motegi, Kentaro Minami, Naoto Kawamatsu, Kimi Sato, Hiroaki Watabe, Tomoko Machino-Ohtsuka, Tomoya Hoshi, Tomoko Ishizu","doi":"10.1016/j.jjcc.2025.08.004","DOIUrl":"10.1016/j.jjcc.2025.08.004","url":null,"abstract":"<p><strong>Background: </strong>The association between early Impella (Abiomed, Inc., Danvers, MA, USA) introduction and outcomes in patients with non-acute coronary syndrome (ACS) cardiogenic shock remains unclear. This study aimed to examine whether early Impella introduction leads to better outcomes in patients with non-ACS.</p><p><strong>Methods: </strong>Patients with non-ACS cardiogenic shock treated with Impella (n = 731), who were registered in the Japanese Registry for Percutaneous Ventricular Assist Devices, were categorized based on the time from admission to Impella introduction (door-to-unloading time): groups A (within 6 h), B (6-24 h), C (1-3 days), and D (>3 days). The primary endpoint was in-hospital mortality; the secondary endpoints included left ventricular ejection fraction (LVEF) at Impella removal and adverse event frequency.</p><p><strong>Results: </strong>In-hospital mortality rates increased with delayed Impella introduction: 25.9 %, 34.2 %, 37.8 %, and 45.0 % in groups A, B, C, and D, respectively, with a significant difference between groups A and D (p < 0.001). The LVEF at Impella removal was significantly higher in group A than in group D [46 (35-57)% vs. 36 (26-50)%, p = 0.01]. Group D was an independent prognostic factor for in-hospital mortality compared with group A in all cohorts [odds ratio (OR), 1.98; 95 % confidence interval (CI), 1.01-3.91; p = 0.04] and in patients with myocarditis (OR, 2.87; 95 % CI, 1.06-7.80; p = 0.04).</p><p><strong>Conclusions: </strong>Early Impella introduction in patients with non-ACS cardiogenic shock is associated with lower in-hospital mortality, especially in those with myocarditis.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862267","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}
Mohammad Iman Shishesaz, Reza Eshraghi, Ashkan Bahrami, Mahour Farzan, Mahan Farzan, Ramtin Hajibeygi, Mobina Fathi, Shirin Yaghoobpoor, Arian Tavasol, Mahmood Gorjizad, Mina Dehghani, AmirHossein Akbari, Nazanin Rafiei, Minoo Roostaie, Samira Eslami, Maryam Taherkhani, Mohammad Reza Movahed
{"title":"The effectiveness and side effects of anti-coagulant drugs in pregnant women with mechanical or bio-prosthetic heart valves: A systematic review and meta-analysis study.","authors":"Mohammad Iman Shishesaz, Reza Eshraghi, Ashkan Bahrami, Mahour Farzan, Mahan Farzan, Ramtin Hajibeygi, Mobina Fathi, Shirin Yaghoobpoor, Arian Tavasol, Mahmood Gorjizad, Mina Dehghani, AmirHossein Akbari, Nazanin Rafiei, Minoo Roostaie, Samira Eslami, Maryam Taherkhani, Mohammad Reza Movahed","doi":"10.1016/j.jjcc.2025.08.002","DOIUrl":"10.1016/j.jjcc.2025.08.002","url":null,"abstract":"<p><strong>Background and objectives: </strong>Patients with pregnancy and mechanical or bio-prosthetic heart valves (BHVs) need tailored antithrombotic therapy to prevent thromboembolism. The goal of this study was to evaluate the effects and complications of various anticoagulation strategies used during pregnancy in these patients using a meta-analysis.</p><p><strong>Method: </strong>We searched PubMed, Google Scholar, Scopus, EMBASE, and Web of Science databases and discovered 24 articles. We also discarded some articles when evaluating them in detail due to inadequate information. Finally, 24 studies were included in the systematic review. We compared pregnancy outcomes in three groups of pregnant women: 1) Those taking warfarin; 2) Those taking LMWH (Low Molecular Weight Heparin) or UFH (Unfractionated Heparin); 3) Those on no anticoagulant therapy. The authors would like to thank the Clinical Research Development Unit (CRDU) of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran for their support, cooperation and assistance throughout the period of study. The ethic code is: IR.SBMU.RETECH.REC.1403.831.</p><p><strong>Results: </strong>The incidence of maternal thromboembolic events was higher in the UFH or LMWH group, but fetal complications (FC) were lower in this group. Using warfarin during the first trimester was associated with a higher abortion rate, embryopathies, and FCs overall. Using <5 mg of warfarin daily to maintain their targeted INR had a lower risk of developing. Preterm labor and spontaneous abortion were observed in 0.09 (95 % CI = 0.04-0.14) and 0.08 (95 % CI = 0.01-0.14) of cases in the LMWH/UFH subgroup. In terms of maternal complications (MCs) in Warfarin subgroup, maternal hemorrhagic complications, maternal thromboembolic events, and valve thrombosis were respectively observed in 2.0 (95 % CI = 0-3), 0.01 (95 % CI = 0.00-0.03), 0.01 (95 % CI = 0.00-0.03); in LMWH subgroup the rates were 0.18 (95 % CI = 0.09-0.27), 0.03 (95 % CI = 0.00-0.06), and 0.28 (95 % CI = 0.15-0.71); and finally in those taking no anticoagulant therapy, the rates were 0.02 (95 % CI = 0.03-0.06), 0.07 (95 % CI = 0.06-0.19).</p><p><strong>Conclusions: </strong>According to the results, preterm labor is a significant fatal complication in pregnant women on warfarin. Maternal hemorrhagic complications and thromboembolic events occur in the LMWH subgroup. There are no significant differences in other complications between the three subgroups.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859250","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}
Hassan Saleh, Kush Patel, Nicholas Pavlatos, Zachary Meili, Thomas Beyerle, Suneil Bhaskara, Emily Converse, John Dillon, Nicholas Stone, Hesham Afify, Prafull Raheja, Ravi Sharma, Sohail Ikram, Naresh Solankhi
{"title":"Impact of orbital and rotational atherectomy on side branch patency in severely calcified coronary artery lesions.","authors":"Hassan Saleh, Kush Patel, Nicholas Pavlatos, Zachary Meili, Thomas Beyerle, Suneil Bhaskara, Emily Converse, John Dillon, Nicholas Stone, Hesham Afify, Prafull Raheja, Ravi Sharma, Sohail Ikram, Naresh Solankhi","doi":"10.1016/j.jjcc.2025.08.003","DOIUrl":"10.1016/j.jjcc.2025.08.003","url":null,"abstract":"<p><p>Severe coronary artery calcification is associated with reduced procedural success and increased long-term adverse events. Orbital atherectomy (OA) and rotational atherectomy (RA) are two commonly used plaque-modification strategies in this setting. However, their comparative impact on side branch (SB) patency remains undefined. To evaluate side branch patency and associated clinical outcomes in patients with severely calcified coronary lesions undergoing OA versus RA. We conducted a single-center, retrospective analysis of 471 patients who underwent coronary atherectomy between January 1, 2021, and December 1, 2024, including 272 treated with OA and 199 with RA. We identified and included lesions with an adjacent SB ≥ 2.0 mm in diameter within 5 mm of the atherectomy treatment area. A total of 151 SB vessels were identified in the OA cohort and 144 in the RA cohort. Post-procedural SB TIMI flow grade was assessed, procedural complications and major adverse cardiovascular events (MACE) were recorded at discharge, 30 days and 1 year. Baseline clinical and angiographic characteristics were similar between the two groups, although adjunctive device use was more frequent in the RA cohort. Balloon angioplasty of the SB was performed more commonly in the RA group (28.5 % v 15.2 % p 0.006), with no significant difference in SB stent implantation (9.9 v 9.7 p 0.951). Post-procedural SB TIMI 3 flow was significantly more frequent in the OA group (adjusted OR 3.99; 95 % CI, 1.46-10.88; p = 0.007). Procedural complications rates and MACE at discharge, 30-days and 1-year were comparable between the two groups. In this single-center, retrospective analysis, orbital atherectomy was associated with higher likelihood of achieving post-procedural SB TIMI 3 flow compared to rotational atherectomy, with similar procedural and long-term outcomes. These findings are hypothesis-generating and highlight the need for further prospective, multicenter studies to define the impact of atherectomy strategy on side branch preservation.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859249","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":"Perivascular adipose tissue in cardiovascular disease: From mechanisms to therapeutic targets.","authors":"Kazutaka Ueda","doi":"10.1016/j.jjcc.2025.08.001","DOIUrl":"10.1016/j.jjcc.2025.08.001","url":null,"abstract":"<p><p>Vascular inflammation plays a pivotal role in the development and progression of cardiovascular pathology. Understanding the mechanisms underlying vascular inflammation is therefore essential for the prevention and treatment of cardiovascular diseases. In recent years, perivascular adipose tissue (PVAT), which surrounds arteries ranging from the aorta to the coronary and peripheral arteries, has emerged as a key player in vascular pathophysiology. Notably, recent clinical trials have demonstrated that antidiabetic agents such as glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors exert cardiovascular benefits beyond glycemic control. Basic and translational studies suggest that these agents may modulate both the quantity and functional phenotype of coronary PVAT, further highlighting its relevance as a therapeutic target. In this review, we summarize the current understanding of the role of PVAT in vascular inflammation and remodeling and discuss its potential as a novel target for the prevention and treatment of cardiovascular diseases.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821547","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}
Muhammad Khubaib Iftikhar, Muhammad Hamza, Mirza Muhammad Ali Baig, Saad Sajjad Khan
{"title":"Unraveling the vascular fallout of TMAO in CKD: Time to look beyond GATA4?","authors":"Muhammad Khubaib Iftikhar, Muhammad Hamza, Mirza Muhammad Ali Baig, Saad Sajjad Khan","doi":"10.1016/j.jjcc.2025.07.011","DOIUrl":"10.1016/j.jjcc.2025.07.011","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789260","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":"Hemodynamic integration of pulmonary artery pulsatility index and compliance for risk stratification in patients with heart failure with reduced ejection fraction.","authors":"Yuta Ozaki, Yusuke Uemura, Toru Kondo, Shingo Kazama, Shogo Yamaguchi, Takashi Okajima, Takayuki Mitsuda, Shinji Ishikawa, Kenji Takemoto, Takahiro Okumura, Toyoaki Murohara, Masato Watarai","doi":"10.1016/j.jjcc.2025.07.012","DOIUrl":"10.1016/j.jjcc.2025.07.012","url":null,"abstract":"<p><strong>Background: </strong>Right ventricular dysfunction (RVD) and right ventricular (RV) afterload are recognized prognostic factors in patients with heart failure with reduced ejection fraction (HFrEF). Hemodynamic phenotyping based on RVD and RV afterload may help identify clinically meaningful subgroups within the HFrEF population. This study aimed to investigate the prognostic associations of pulmonary artery pulsatility index (PAPi) and pulmonary arterial capacitance (PAC) in patients with HFrEF.</p><p><strong>Methods and results: </strong>We retrospectively analyzed a cohort of 156 patients with HFrEF who underwent right heart catheterization. Patients were categorized into four groups based on median PAPi and PAC values. The primary endpoint was a composite of cardiovascular death or heart failure-related hospitalization over a median follow-up of 2.9 years. Kaplan-Meier analysis demonstrated a significant difference in event-free survival across the groups. In multivariate Cox proportional analysis, patients with low PAPi and PAC had significantly worse outcomes than those with high values. Incorporating PAPi and PAC values into the Meta-analysis Global Group in Chronic Heart Failure risk score enhanced the prognostic value of the C-index from 0.658 to 0.703, with a ΔC-index of 0.045.</p><p><strong>Conclusion: </strong>Combining PAPi and PAC provides additional prognostic value in patients with HFrEF. Incorporating these parameters into clinical assessment may enhance risk stratification and guide future phenotype-specific therapeutic strategies.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804189","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}
Journal of cardiologyPub Date : 2025-08-01Epub Date: 2025-02-08DOI: 10.1016/j.jjcc.2025.02.001
Ahad Firoz, Huaqing Zhao, Eman Hamad
{"title":"Relationship between body mass index and traditional size-matching in heart transplantation.","authors":"Ahad Firoz, Huaqing Zhao, Eman Hamad","doi":"10.1016/j.jjcc.2025.02.001","DOIUrl":"10.1016/j.jjcc.2025.02.001","url":null,"abstract":"<p><strong>Background: </strong>Donor-recipient size matching is an important consideration for heart allocation, of which predicted heart mass (PHM) ratio has been found to be the most optimal metric. However, the PHM formula has not been validated in a cohort that included obese recipients. Therefore, our study seeks to add further granular data on this topic by investigating acute survival in PHM categories across multiple body mass index (BMI) groups.</p><p><strong>Methods: </strong>Adult heart transplant recipients were analyzed using the United Network for Organ Sharing database. BMI groups included: normal (18.5-24.9 kg/m<sup>2</sup>), overweight (25.0-29.9 kg/m<sup>2</sup>), obese class I (30.0-34.9 kg/m<sup>2</sup>), and obese class II+ (≥35.0 kg/m<sup>2</sup>). PHM ratio (PHMR) categories were: severely undersized (U2): <0.85, undersized (U1): 0.85-0.95, approximately equally sized (R): 0.95-1.05, oversized (O1): 1.05-1.25, and severely oversized (O2): ≥1.25. All-cause acute mortality was the primary outcome of interest.</p><p><strong>Results: </strong>A total of 46,141 recipients were included in our analysis. The percentage of obese patients and donors increased over the years, from 21.5 % and 17.2 % in 2000 to 34.4 % and 33.1 % in 2022, respectively. Survival analysis found a stepwise reduction in mortality risk for severely undersized grafts as BMI increased (normal: HR = 1.59, p < 0.001; overweight: HR = 1.20, p = 0.029), until ultimately reaching insignificant levels in obese groups across all PHMR categories.</p><p><strong>Conclusion: </strong>Patients with a normal to overweight BMI were susceptible to increased mortality with a severely undersized graft. Conversely, obese groups appeared to be resistant to the hazards of organ size mismatching by PHMR. The clinical implications of this study may enable recruitment from a larger donor pool and improve challenges in transplantation for obese patients.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":"172-178"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390797","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}