Journal of Clinical Medicine最新文献

{"title":"Alternative Transaxillary Access for Transcatheter Aortic Valve Implantation.","authors":"Konrad Wisniewski, Gerrit Kaleschke, Fernando De-Torres-Alba, Sven Martens, Heinz Deschka","doi":"10.3390/jcm14145127","DOIUrl":"10.3390/jcm14145127","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Currently, the transfemoral approach is recognized as the primary method for accessing transcatheter aortic valve implantation (TAVI). However, alternative techniques are needed when the transfemoral access is not suitable. We proposed that a modified transaxillary approach through the distal left axillary artery is both viable and safe for conducting TAVI, potentially offering benefits for patients. <b>Methods:</b> From December 2018 to February 2024, a total of 24 patients (7 women, average age 77.9 ± 8 years) received TAVI using transaxillary access via the left axillary artery. The participants suffered from symptomatic severe aortic stenosis and were deemed TAVI candidates with iliofemoral anatomy unsuitable for a transfemoral route. The patient group displayed a high perioperative risk profile, with significant peripheral artery disease or severe obstructive infrarenal aortic conditions. The implantation of the aortic prosthesis was carried out through the left distal axillary artery. A balloon-expandable valve was used in every instance. <b>Results:</b> In the examined cohort, the 30-day mortality rate was 4.2%. A new pacemaker was necessary for four patients (16.7%). One case exhibited a new moderate neurological dysfunction. Additionally, one patient required surgical revision of the access point due to ischemia. <b>Conclusions:</b> Our findings indicate that transaxillary TAVI via the distal left axillary artery has yielded encouraging outcomes. This approach is practicable and safe, does not prolong the procedure, minimizes surgical trauma, ensures excellent access regardless of chest anatomy, and is sparing for the brachial plexus. As a single-center pilot study, our findings require confirmation in larger, prospective cohorts with extended follow-up to fully validate the safety and long-term efficacy of this technique.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 14","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12295515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autogenous Transplantation of Teeth Across Clinical Indications: A Systematic Review and Meta-Analysis.","authors":"Martin Baxmann, Karin Christine Huth, Krisztina Kárpáti, Zoltán Baráth","doi":"10.3390/jcm14145126","DOIUrl":"10.3390/jcm14145126","url":null,"abstract":"<p><p>Autogenous tooth transplantation offers a biologically favorable approach to tooth replacement, preserving the periodontal ligament, promoting alveolar development, and maintaining proprioception. <b>Background/Objectives</b>: Its broader clinical applicability is limited by variability in techniques and outcome definitions. This systematic review and meta-analysis evaluated the clinical success of autogenous tooth transplantation across donor tooth types, developmental stages, surgical techniques, and fixation methods. <b>Methods</b>: Following PRISMA 2020 guidelines and a PROSPERO-registered protocol (CRD42024625550), five databases and the gray literature were searched through July 2025. Eligible studies reported clinical outcomes for autogenous tooth transplantation. Risk of bias was assessed using the Newcastle-Ottawa Scale. A random-effects meta-analysis of logit-transformed proportions was conducted, with subgroup and sensitivity analyses by tooth type, root development stage, surgical technique, and fixation method. <b>Results</b>: Twenty studies involving 1366 transplanted teeth were included. The pooled success rate was 94.0% (95% CI: 22.5-99.9%) across follow-up periods ranging from one month to twenty-nine years. However, interpretation is limited by distinct heterogeneity (I² = 99.8%) and the wide confidence interval. Subgroup analyses by tooth type, root maturity, surgical technique, and fixation method are, therefore, emphasized to support clinical interpretation. <b>Conclusions</b>: Autogenous tooth transplantation achieves consistently high success across clinical contexts when biologic handling is respected. These findings support its broader use in dental and orthodontic practice and underscore the need for standardized outcome reporting and prospective research. Interpretation is limited by heterogeneity and variation in reporting standards.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 14","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12295735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Probiotics as an Adjunct to Non-Surgical Periodontal Therapy (NSPT): A Narrative Review.","authors":"Leopoldo Mauriello, Alessandro Cuozzo, Vitolante Pezzella, Vincenzo Iorio-Siciliano, Gaetano Isola, Gianrico Spagnuolo, Luca Ramaglia, Andrea Blasi","doi":"10.3390/jcm14145114","DOIUrl":"10.3390/jcm14145114","url":null,"abstract":"<p><p><b>Background:</b> Periodontitis is a chronic inflammatory disease characterized by the destruction of periodontal tissues due to biofilm deposits and altered host immune response. Non-surgical periodontal therapy (NSPT) still represents the gold standard for treatment; however, its effectiveness in deep periodontal pockets is limited. Probiotics seem to modulate both oral microbiota and inflammatory response and have been proposed as an adjunctive therapy to NSPT. <b>Methods</b>: An electronic search was conducted on PubMed, Scopus, Medline, and Google Scholar to identify English randomized controlled trials (RCTs) evaluating probiotics as adjunctive treatments to NSPT. Studies were selected based on inclusion and exclusion criteria, and clinical outcomes such as probing depth (PD) and clinical attachment level (CAL) were extracted and analyzed. <b>Results</b>: Seven RCTs met the inclusion criteria. These studies showed significant improvements in PD and CAL when probiotics were used, specifically with <i>Lactobacillus</i> and <i>Bifidobacterium</i> species. However, outcomes ranged depending on the strain, dosage, and delivery method. <b>Conclusions</b>: Probiotics may be used as an adjunct treatment to NSPT; however, further studies are needed to define valid clinical guidelines.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 14","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12295585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Cope with Coping in Adult Post-Hemorrhagic Patients Undergoing Neurorehabilitation: A Scoping Review.","authors":"Davide Cardile, Irene Cappadona, Erika Patti, Aurora Ansaldo, Rosaria De Luca, Francesco Corallo, Maria Pagano, Anna Anselmo, Angelo Quartarone, Rocco Salvatore Calabrò","doi":"10.3390/jcm14145121","DOIUrl":"10.3390/jcm14145121","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Cerebral hemorrhage (CH) has physical, cognitive, and emotional consequences. Recovery requires a complex rehabilitation process in which coping strategies play a fundamental role in supporting psychological adaptation. The aim of this study is to investigate and understand the extent and manner in which coping strategies have been assessed in the CH population within the scientific literature. <b>Methods:</b> Studies were identified through searches in the PubMed, Scopus, and Embase databases. Eight studies published between 2014 and 2024 were selected. <b>Results:</b> The most frequently adopted coping strategies include task-oriented coping, avoidance, emotion-focused coping, acceptance, planning, and emotional support. Task-oriented strategies and acceptance are associated with better psychological outcomes. Conversely, avoidant and emotion-focused strategies correlate with higher levels of anxiety, depression, and poorer adaptation. Resilience and social participation emerge as protective factors. Finally, Action/Distraction is associated with a better quality of life, while Trivialization/Resignation is linked to lower levels. <b>Conclusions:</b> Coping seems to represent a modifiable, patient-centered lever that can mitigate the psychosocial sequelae of intracranial hemorrhage when assessed systematically and addressed through tailored rehabilitation programs. Our findings lay the groundwork for evidence-based, coping-focused interventions and highlight critical avenues for future longitudinal and mechanistic research.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 14","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12295125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health as Assessed by the Symptom Checklist 90 (SCL-90) Scores in Women with and Without Polycystic Ovary Syndrome.","authors":"Marie-Louise Marschalek, Rodrig Marculescu, Christian Schneeberger, Julian Marschalek, Marlene Hager, Robert Krysiak, Johannes Ott","doi":"10.3390/jcm14145103","DOIUrl":"10.3390/jcm14145103","url":null,"abstract":"<p><p><b>Background and Objectives</b>: Polycystic ovary syndrome (PCOS) is associated with an elevated risk of impaired mental health and psychiatric disorders, such as depression and anxiety. Physical factors like weight and hirsutism, as well as psychological factors, such as self-esteem and coping strategies, are all known to have an influence on mental health status. <b>Aim:</b> To assess psychological symptoms in women with and without PCOS, by use of the well-established, validated self-report questionnaire: Symptom Checklist-90-Revised (SCL-90); to determine the reliability of the SCL-90 for assessment of PCOS patients. <b>Design</b>: Prospective case-control study. <b>Methods</b>: Psychological symptoms were assessed using the German version of the SCL-90 in 31 PCOS women and 31 healthy controls. To test the impact of various parameters on numerical outcome parameters, correlation analyses were conducted. <b>Results</b>: PCOS women revealed significantly increased SCL-90 scores in seven out of the nine subscales (hostility subscale, anxiety subscale, depression subscale, paranoid ideation subscale, psychoticism subscale, somatization subscale, interpersonal sensitivity subscale, obsessive compulsive subscale), as well as in all three global indices (<i>p</i> < 0.05). SCL-90 scores were significantly positively correlated with perceived total stress and perceived helplessness and significantly negatively correlated with perceived self-efficacy (<i>p</i> < 0.05). <b>Conclusions</b>: PCOS women experienced higher levels of psychological symptoms including depressive and anxiety symptoms. Higher perceived stress, higher perceived helplessness and lower self-efficacy were associated with more psychological symptoms. Hence, there is a need to support PCOS women with their emotional regulation and coping strategies.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 14","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12295920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Splenic Torsion Following Blunt Abdominal Trauma.","authors":"Piotr Tomasz Arkuszewski, Agata Grochowska, Wiktoria Jachymczak, Karol Kamil Kłosiński","doi":"10.3390/jcm14145107","DOIUrl":"10.3390/jcm14145107","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Splenic torsion is a well-known and reported clinical problem. Splenic torsions after abdominal trauma represent a small group of cases that involve surgical management. They manifest primarily as abdominal pain, and the diagnosis is made based on imaging studies-ultrasound, CT, and MRI. <b>Methods</b>: This work aimed to analyze traumatic splenic torsions in terms of their clinical course, symptoms, timing, involvement of imaging techniques in the diagnosis, histopathological examination, and overall outcome. We searched databases using the desk research method under the keywords \"splenic torsion\", \"torsion\", and \"spleen\", as well as in combination with \"traumatic\", finding a total of eight cases, which we included in our analysis. <b>Results</b>: The eight cases were analyzed, comprising four females and four males, with an average age of 16.25 years (range 5-29 years). Traffic accidents were the most frequent cause of injury (five cases), while the circumstances were unclear in the remaining three. Immediate abdominal symptoms appeared in six patients. Splenic torsion was preoperatively diagnosed in five out of seven confirmed cases. A total of seven patients underwent laparotomy with splenectomy. In one case, laparoscopy converted to laparotomy with splenopexy preserved the spleen. Histopathology, performed in only two cases, confirmed splenic infarction in one patient; infarction status could not be determined in the remaining five due to missing data. <b>Conclusions</b>: Post-traumatic splenic torsions are a group of atypical injuries as the primary and immediate consequence of the trauma suffered is not anatomical-structural damage to the organ, such as a rupture. Mostly affecting young people, the cases described in the professional literature involve the main spleen, which was considered to be \"wandering\", suggesting that this is a key predisposing factor for splenic torsion following blunt trauma and requiring diagnostic imaging for diagnosis.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 14","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12295792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Two Types of Robotic Single-Site Myomectomy Using Propensity Score Matching: Coaxial with da Vinci Xi vs. da Vinci SP System.","authors":"Nara Lee, Su Hyeon Choi, Mi-La Kim, Sa Ra Lee, Seok Ju Seong","doi":"10.3390/jcm14145106","DOIUrl":"10.3390/jcm14145106","url":null,"abstract":"<p><p><b>Background</b>: This study was designed to evaluate and contrast the surgical outcomes between coaxial robotic single-site myomectomy (RSSM) performed using the da Vinci Xi system and da Vinci SP system. <b>Methods</b>: A retrospective review was conducted on 81 women who underwent coaxial RSSM and 108 women who underwent myomectomy with the da Vinci SP system between October 2020 and January 2024. Propensity score matching was performed based on myoma count, the dominant myoma's maximum diameter, and the myoma type according to the International Federation of Gynecology and Obstetrics (FIGO) classification. Patient characteristics and surgical outcomes were evaluated and compared between the two groups. <b>Results</b>: Compared to the SP group, the coaxial RSSM group showed significantly lower estimated blood loss (102.33 ± 61.01 vs. 203.98 ± 163.15 mL, <i>p</i> < 0.001), shorter operative time (91.22 ± 18.25 vs. 148.69 ± 45.62 min, <i>p</i> < 0.001), and smaller hemoglobin decrement (1.69 ± 0.93 vs. 2.85 ± 1.30, <i>p</i> < 0.001). However, hospital stay was shorter in the SP group than in the coaxial group (2.06 ± 0.24 vs. 4.07 ± 0.76 days, <i>p</i> < 0.001). There were no statistically significant differences in postoperative complications, including ileus, fever, or wound dehiscence. Additional comparisons using cases performed by four different surgeons yielded results consistent with the one-to-one surgeon comparison. <b>Conclusions</b>: Coaxial RSSM was associated with a shorter operative time and lower blood loss compared to SP myomectomy. A prospective study is warranted to validate and further compare the surgical outcomes of the two techniques.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 14","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12295487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dr. LLM Will See You Now: The Ability of ChatGPT to Provide Geographically Tailored Colorectal Cancer Screening and Surveillance Recommendations.","authors":"Aisling Zeng, Jacqueline Steinke, Horea-Florin Bocse, Matteo De Pastena","doi":"10.3390/jcm14145101","DOIUrl":"10.3390/jcm14145101","url":null,"abstract":"<p><p><b>Background/Objectives</b>: This study evaluates the performance of a large language model (lLm) in providing geographically tailored colorectal cancer screening and surveillance recommendations to gastrointestinal surgeons. <b>Methods</b>: Fifty-four patient cases, varying by age and family history, were developed based on colorectal cancer guidelines. Standardized prompts with predefined query terms were used to query ChatGPT-4.5 on 18 April 2025, from four locations: Canada, Italy, Romania, and the United Kingdom. Responses were classified as \"Correct,\" \"Partially Correct,\" or \"Incorrect\" based on clinical guidelines and expert recommendations for each country. Outcomes were analyzed using descriptive statistics. <b>Results</b>: ChatGPT provided recommendations on screening eligibility, test interpretation, the management of positive results, and surveillance intervals. Correct recommendations were given for 50.0% (27/54) of cases in Canada, 63.0% (34/54) of cases in Italy, 40.7% (22/54) of cases in Romania, and 55.6% (30/54) of cases in the United Kingdom. Queries in Italian yielded correct guidance for 64.8% (35/54) of cases, while Romanian queries were accurate for 40.7% (22/54) of cases. Notably, Romania and Italy lacked detailed guidelines for polyp management and post-test surveillance. A key finding was the inconsistency between ChatGPT-generated titles and corresponding recommendations, which may impact its reliability in clinical decision-making. <b>Conclusions</b>: ChatGPT-4.5's performance varies by country and language, highlighting inconsistencies in geographically tailored recommendations. This study highlights limitations associated with the training data cutoff and the potential biases introduced by model-generated responses. Healthcare professionals should recognize these limitations and the possible gaps in guideline availability, particularly for high-risk screening, polyp management, and surveillance in certain European countries.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 14","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12294925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, Outcomes and Healthcare Costs of Postoperative ARDS Compared with Medical ARDS.","authors":"Miguel Bardají-Carrillo, Rocío López-Herrero, Mario S Espinoza-Fernández, Lucía Alonso-Villalobos, Rosa Cobo-Zubia, Rosa Prieto-Utrera, Irene Arroyo-Hernantes, Esther Gómez-Sánchez, Luigi Camporota, Jesús Villar, Eduardo Tamayo","doi":"10.3390/jcm14145125","DOIUrl":"10.3390/jcm14145125","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Postoperative acute respiratory distress syndrome (ARDS) is a recognized complication with reported prevalence rates of up to 20% and highly variable mortality. However, there is limited published evidence comparing the outcomes of postoperative ARDS with those of medical ARDS. We aimed to evaluate the prevalence, hospital mortality, and healthcare costs of postoperative ARDS in Spain between 2000 and 2022 and to compare them with those of medical ARDS. <b>Methods</b>: We performed a nationwide, registry-based study of all hospitalizations for postoperative ARDS in Spain between 1 January 2000 and 31 December 2022 using the Minimum Basic Data Set (MBDS) Registry. <b>Results</b>: We identified a total of 93,192 ARDS patients, of which 40,601 had postoperative ARDS. The postoperative ARDS prevalence varied between 0.05 and 0.22%, accounting for 45-50% of total ARDS cases recorded during the study period. Hospital mortality was lower in postoperative ARDS compared with medical ARDS during the first phase (2000-2015) (47.0% vs. 49.9%, <i>p</i> < 0.001) and converged during the second phase (2017-2022) (42.7% vs. 43.2%, <i>p</i> = 0.413). Postoperative ARDS was associated with a longer hospital stay and 1.5 times higher healthcare costs compared with medical ARDS. During the COVID-19 pandemic, mortality rates declined but costs peaked in both groups. The incidence of digestive tract infection was higher in postoperative ARDS. <b>Conclusions</b>: The prevalence of postoperative ARDS remained stable, except during the COVID-19 pandemic, and its hospital mortality declined and equalized with that of medical ARDS. However, the costs associated with postoperative ARDS remained significantly higher.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 14","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12295955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Frontal QRS-T Angle and Non-Alcoholic Fatty Liver Disease (NAFLD) Fibrosis Score in Patients with Stable Angina Pectoris.","authors":"Ali Gökhan Özyıldız, Afag Özyıldız, Hüseyin Durak, Nadir Emlek, Mustafa Çetin","doi":"10.3390/jcm14145117","DOIUrl":"10.3390/jcm14145117","url":null,"abstract":"<p><p><b>Aim:</b> The frontal QRS-T (fQRS-T) angle serves as an electrocardiography indicator that visually represents the disparity between the frontal QRS axis and the T axis. The heterogeneity between cardiac depolarization and repolarization rises with an increase in the fQRS-T angle. Prior research has demonstrated a relationship between the fQRS-T angle and the extent of atherosclerosis, along with the risk of cardiovascular mortality. The non-alcoholic fatty liver disease fibrosis score (NFS) is a non-invasive scoring tool used to quantify the degree of liver fibrosis in individuals with non-alcoholic fatty liver disease (NAFLD). Non-alcoholic fatty liver disease increases the risk of atherosclerotic cardiovascular disease, which can be predicted using the NFS. The objective of this study is to examine the potential correlation between the fQRS-T angle and NFS in patients with stable angina pectoris. <b>Materials and Methods:</b> This cross-sectional study included 177 (48 women) non-alcoholic patients who underwent coronary angiography due to stable angina pectoris. Individual NFS values were calculated using clinical and laboratory data. Patients were categorized into two groups based on a NFS threshold value of 0.67. Following a minimum fasting period of 12 h, biochemical laboratory parameters were acquired using a peripheral venous sample, and electrocardiographic data were recorded. <b>Results:</b> The univariate logistic regression analysis revealed significant associations between hypertension (<i>p</i> = 0.018), coronary artery disease (<i>p</i> = 0.014), neutrophil (<i>p</i> = 0.024), hemoglobin (<i>p</i> = 0.038), and low-density lipoprotein (LDL, <i>p</i> = 0.007) with the NFS. The electrocardiographic variables related to the score included the QRS duration (<i>p</i> = 0.015), Pmax (<i>p</i> = 0.026), QTC interval (<i>p</i> = 0.02), and fQRS-T angle (<i>p</i> < 0.001). In the multivariate logistic regression analysis, NFS was independently associated with LDL (OR: 0.984, 95% CI: 0.970-0.998, <i>p</i> = 0.024) and fQRS-T angle (OR: 3.472, 95% CI: 1.886-6.395, <i>p</i> < 0.001). <b>Conclusions:</b> The FQRS-T angle may exhibit a distinct correlation with NAFLD. Extensive investigations should validate this link, since the fibrosis score can serve as an effective tool for monitoring patients prior to the onset of clinical symptoms associated with liver fibrosis.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 14","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12295152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}