Open Heart最新文献

{"title":"Machine learning to predict high-risk coronary artery disease on CT in the SCOT-HEART trial.","authors":"Michelle Claire Williams, Alan R M Guimaraes, Muchen Jiang, Jacek Kwieciński, Jonathan R Weir-McCall, Philip D Adamson, Nicholas L Mills, Giles H Roditi, Edwin J R van Beek, Edward Nicol, Daniel S Berman, Piotr J Slomka, Marc R Dweck, David E Newby, Damini Dey","doi":"10.1136/openhrt-2025-003162","DOIUrl":"10.1136/openhrt-2025-003162","url":null,"abstract":"<p><strong>Background: </strong>Machine learning based on clinical characteristics has the potential to predict coronary CT angiography (CCTA) findings and help guide resource utilisation.</p><p><strong>Methods: </strong>From the SCOT-HEART (Scottish Computed Tomography of the HEART) trial, data from 1769 patients was used to train and to test machine learning models (XGBoost, 10-fold cross validation, grid search hyperparameter selection). Two models were separately generated to predict the presence of coronary artery disease (CAD) and an increased burden of low-attenuation coronary artery plaque (LAP) using symptoms, demographic and clinical characteristics, electrocardiography and exercise tolerance testing (ETT).</p><p><strong>Results: </strong>Machine learning predicted the presence of CAD on CCTA (area under the curve (AUC) 0.80, 95% CI 0.74 to 0.85) better than the 10-year cardiovascular risk score alone (AUC 0.75, 95% CI 0.70, 0.81, p=0.004). The most important features in this model were the 10-year cardiovascular risk score, age, sex, total cholesterol and an abnormal ETT. In contrast, the second model used to predict an increased LAP burden performed similarly to the 10-year cardiovascular risk score (AUC 0.75, 95% CI 0.70 to 0.80 vs AUC 0.72, 95% CI 0.66 to 0.77, p=0.08) with the most important features being the 10-year cardiovascular risk score, age, body mass index and total and high-density lipoprotein cholesterol concentrations.</p><p><strong>Conclusion: </strong>Machine learning models can improve prediction of the presence of CAD on CCTA, over the standard cardiovascular risk score. However, it was not possible to improve the prediction of an increased LAP burden based on clinical factors alone.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticoagulation and antiplatelet strategies used in Sweden in patients with myocardial infarction and concomitant atrial fibrillation: nationwide cohort study.","authors":"Julia Aulin, Angelo Modica, Lars Lindhagen, Joakim Alfredsson, Claes Held, Stefan James, Gorav Batra","doi":"10.1136/openhrt-2025-003472","DOIUrl":"10.1136/openhrt-2025-003472","url":null,"abstract":"<p><strong>Background: </strong>Optimal antithrombotic therapy and its duration, whether triple therapy with dual antiplatelets plus oral anticoagulant (OAC), or dual antithrombotic therapy with an antiplatelet plus OAC, is uncertain for patients with myocardial infarction (MI) and atrial fibrillation (AF).</p><p><strong>Methods: </strong>Patients registered in SWEDEHEART (Swedish Web-system for enhancement and development of evidence-based care in heart disease evaluated according to recommended therapies) for their first MI between 2011 and 2021 with a history or new-onset AF were included (n=26 574). Linkage between SWEDEHEART and Swedish administrative health databases was performed, and pseudonymised data analysed.</p><p><strong>Results: </strong>Over time, OAC use at discharge after MI tripled from 27% in 2011 to 77% in 2021, with direct OACs (DOACs) largely replacing warfarin, predominantly in combination with a single antiplatelet. The strongest factors for initiating OAC therapy were the performance of coronary angiography (OR 1.53 (1.40-1.68)), and percutaneous coronary intervention (OR 1.49 (1.39-1.61)). However, the year of the MI was the most predictive variable associated with OAC initiation, with an OR of 9.31 (7.92-10.95) in 2021 compared with 2011. The clinical factors associated with lower likelihood of OAC initiation were dementia, liver disease, cancer and ST-elevation MI (STEMI) versus non-STEMI.</p><p><strong>Conclusions: </strong>Use of OAC has increased over the years in patients with MI and concurrent AF, primarily driven by the increased adoption of DOACs. Additionally, there has been a shift in antithrombotic combinations, with most patients in recent years receiving DOAC in combination with a single antiplatelet, reflecting the nationwide implementation of recent evidence and guidelines. However, significant variation in antithrombotic therapy strategies remains.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MAGGIC risk score-based risk stratification for selecting patients with heart failure who will benefit from multidisciplinary care.","authors":"Yoshiharu Kinugasa, Kensuke Nakamura, Masayuki Hirai, Midori Manba, Natsuko Ishiga, Takeshi Sota, Natsuko Nakayama, Tomoki Ota, Masahiko Kato, Masaru Kato","doi":"10.1136/openhrt-2025-003496","DOIUrl":"10.1136/openhrt-2025-003496","url":null,"abstract":"<p><strong>Objective: </strong>Guidelines worldwide recommend specialist outpatient clinics staffed by a multidisciplinary team for management of patients with heart failure (HF). However, there is limited information on how best to select these patients for efficient use of resources. This study aimed to determine the effectiveness of team-based care for patients with HF after discharge from hospital according to duration of intervention and stratification of patients according to risk.</p><p><strong>Methods: </strong>We retrospectively identified 185 eligible patients who were hospitalised with acute decompensated HF at our institution between January 2021 and June 2023. Multidisciplinary team care was defined as outpatient follow-up by both cardiologists and nurses postdischarge. The primary outcome was a composite of cardiovascular-related death and readmission with HF within 1 year, which was compared between patients receiving HF team care and those receiving standard follow-up.</p><p><strong>Results: </strong>HF team care was provided for 53.0% of patients, who were younger than those receiving standard follow-up and required more oral inotropes, tolvaptan and amiodarone. Among those receiving HF team care, the majority (58.2%) had an intervention duration of 30 days or less after discharge. After adjusting for background differences by inverse probability of treatment weighting, HF team care was associated with favourable 180-day outcomes, but there was no significant between-group difference in the 1-year primary outcomes. In subgroup analysis, patients with a higher Meta-Analysis Global Group in Chronic Heart Failure score (≥28), indicating a higher risk of exacerbation of HF, had significantly lower 1-year event rates with HF team care (p value for interaction <0.05).</p><p><strong>Conclusions: </strong>Multidisciplinary HF team care is most effective for patients at higher risk of exacerbation of HF. A risk score model may optimise patient selection for specialised care.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between left ventricular wall stress and cardiac remodelling post-TAVR and MitraClip.","authors":"Stavroula Papapostolou, John Shapland Kearns, Benedict Costello, Jessica O'Brien, Sarah Gutman, Shane Nanayakkara, David M Kaye, Antony Walton, James Hare, Dion Stub, Andrew Taylor","doi":"10.1136/openhrt-2025-003268","DOIUrl":"10.1136/openhrt-2025-003268","url":null,"abstract":"<p><strong>Background: </strong>The relationship between left ventricular wall stress (LVWS) and cardiac remodelling post structural intervention has not previously been examined. We examined the relationship between LVWS and cardiac remodelling 6 months post transcatheter aortic valve replacement (TAVR) and MitraClip (MC).</p><p><strong>Methods: </strong>LVWS was calculated in 40 patients with severe aortic stenosis (AS) and 11 patients with severe mitral regurgitation (MR) immediately preintervention and postintervention with TAVR or MC. LVWS was calculated by integrating invasive haemodynamic data with cardiac MR (CMR)-derived measures of left ventricular (LV) volume and mass. Patients underwent a 6 min walk test (6MWT), transthoracic echocardiogram and CMR preprocedure and 6 months postprocedure.</p><p><strong>Results: </strong>Both TAVR and MC resulted in significant improvements in functional capacity and cardiac remodelling with no significant difference in the degree of LV mass or volume reduction between the two groups.Linear regression analysis showed that baseline diastolic LVWS (D-LVWS) in the MC cohort and baseline systolic LVWS (S-LVWS) in the TAVR cohort were predictors of larger LV end-diastolic volumes (EDV) and lower ejection fractions (EF) at follow-up (in the MC cohort: B=7.86, p=0.015 for EDV, B=-1.4, p=0.02 for EF; in the TAVR cohort: B=1.53, p=0.04 for EDV and B=-0.702, p<0.001 for EF).</p><p><strong>Conclusions: </strong>Higher baseline D-LVWS in patients undergoing MC, and higher baseline S-LVWS in patients undergoing TAVR, were predictors of poorer EF and larger LV volumes at follow-up. These findings suggest that LVWS may be used to predict the degree of LV recovery postprocedure and suggest that intervening below a certain LVWS threshold may lead to better outcomes with regards to cardiac remodelling.</p><p><strong>Condensed abstract: </strong>LVWS was calculated in patients with AS and mitral regurgitation (MR) pre and immediately post valve intervention with TAVR or MC. The patients were followed up at 6 months with 6MWT, echocardiography and CMR imaging Both cohorts demonstrated significant functional improvements and cardiac remodelling postprocedure. Baseline D-LVWS in MC and baseline S-LVWS in TAVR were predictors of poorer EF and larger LV volumes at follow-up. This suggests that in patients with severe AS or MR, baseline LVWS may be useful to predict degree of recovery postintervention or determine need for early intervention.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic role of exercise intensity in familial Filamin C truncating variants.","authors":"Giulio Savonitto, Alessia Paldino, Martina Setti, Samuel Furlan, Irena Tavcar, Flavio Luciano Ribichini, Maria Perotto, Marta Gigli, Luisa Mestroni, Matteo Dal Ferro, Marco Merlo, Gianfranco Sinagra","doi":"10.1136/openhrt-2025-003502","DOIUrl":"10.1136/openhrt-2025-003502","url":null,"abstract":"<p><strong>Background: </strong>Truncating variants in the Filamin C (<i>FLNCtv</i>) gene are causative of highly arrhythmogenic cardiomyopathies. Guidelines remain controversial concerning competitive and high-intensity sports for <i>FLNCtv</i> carriers. Indeed, the impact of high-intensity exercise on individuals carrying these variants remains poorly understood.</p><p><strong>Methods and results: </strong>This retrospective study analysed 45 probands and relatives carrying <i>FLNCtv</i>, collecting data on previous physical activity. Over a mean follow-up of 4.9±0.6 years, 9 individuals (20%) experienced life-threatening arrhythmias (LTA). No significant association was found between history of higher-intensity exercise and increased LTA risk (OR 1.442; 95% CI 0.321 to 6.467; p=0.633), left ventricular systolic dysfunction (OR 0.505; 95% CI 0.143 to 1.791; p=0.290) or right ventricular dysfunction (OR 3.333; 95% CI 0.263 to 42.212; p=0.353). However, three phenotype-positive subjects (7%), mostly with dilated cardiomyopathy, experienced LTA during intense exercise.</p><p><strong>Conclusions: </strong>Over a mean follow-up of 5 years, high-intensity exercise did not appear to be associated with an increased risk of LTA or structural cardiac disease in <i>FLNCtv</i> carriers. However, we report LTA in already affected subjects during intense exercise. These findings indicate that further investigations may lead to a re-evaluation of exercise recommendations for phenotype-negative carriers and highlight the importance of larger population-based studies on this topic.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term clinical outcomes in adult congenital aortic stenosis: results from a national study.","authors":"Zoë A Keuning, Frederike Meccanici, Bibi A Schreurs, Kevin Veen, Berto J Bouma, Michiel Voskuil, Monique R M Jongbloed, Joost P van Melle, Roland R J van Kimmenade, Rowina Kapoor, Irem Bozkurt, Alexander Hirsch, Jolien W Roos-Hesselink, Annemien E van den Bosch","doi":"10.1136/openhrt-2025-003534","DOIUrl":"10.1136/openhrt-2025-003534","url":null,"abstract":"<p><strong>Background: </strong>Previous research on congenital aortic stenosis (AS) mainly focused on children, while data on long-term outcomes in adults is scarce. Therefore, this study aims to evaluate outcomes in adult patients with congenital AS and identify prognostic markers for aortic valve replacement (AVR).</p><p><strong>Methods: </strong>In this multicentre study, patients aged 18-55 years with congenital AS (peak velocity ≥2.5 m/s) registered in the Dutch CONCOR (Congential Cor Vitia) registry from expert centres for congenital heart disease between 2001 and 2019 were included. Exclusion criteria were severe aortic regurgitation (AR) or prior AVR. Associations with the composite endpoint of all-cause mortality and AVR were assessed with multivariable Cox regression.</p><p><strong>Results: </strong>Of the 427 included patients (median age 26 years, 62.5% male) median aortic peak velocity was 3.1 (IQR 2.7-3.6) m/s, 35% had moderate AR and 29% showed signs of left ventricular (LV) remodelling. During a median follow-up period of 7.9 (IQR 4.1-12.6) years, 7 patients died (1.6%) and 177 patients underwent AVR (41.5%). LV systolic dysfunction was the primary indication for AVR in three patients (1.7%). Peak velocity at baseline (HR 3.17, 95% CI 2.29 to 4.39), non-sinus rhythm (HR 3.12, 95% CI 1.62 to 6.02) and concentric LV geometry (HR 1.64, 95% CI 1.04 to 2.58) were associated with the primary endpoint beside age. Significant male-female differences were observed in prognostic factors for the primary endpoint.</p><p><strong>Conclusion: </strong>AVR was often indicated in adult patients with congenital AS, even if the stenosis at baseline was mild. Moreover, monitoring LV remodelling alongside severity of AS is more important than focusing on systolic LV dysfunction.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rediscovering the atrioventricular node artery: anatomical reappraisal of Bonapace's branch.","authors":"Saurabh Kumar Gupta","doi":"10.1136/openhrt-2025-003587","DOIUrl":"https://doi.org/10.1136/openhrt-2025-003587","url":null,"abstract":"","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium-glucose cotransporter-2 inhibitors and the risk of all-cause mortality: a population-based cohort study using the UK Clinical Practice Research Datalink.","authors":"Talip E Eroglu, Ruben Coronel, Patrick C Souverein","doi":"10.1136/openhrt-2025-003254","DOIUrl":"https://doi.org/10.1136/openhrt-2025-003254","url":null,"abstract":"<p><strong>Aim: </strong>Sodium-glucose cotransporter-2 inhibitors (SGLT-2is) have a direct cardiac effect that is independent of their glucose-lowering renal effect. We investigated the relation between SGLT-2is and all-cause mortality compared with (1) dipeptidyl peptidase-4 inhibitors (DPP-4is) and (2) metformin monotherapy in type 2 diabetes among subjects with a diabetes duration of <5 years at cohort entry.</p><p><strong>Methods: </strong>A cohort study was conducted among patients initiating a new antidiabetic drug class between January 2013 and September 2020 by extracting data from the UK Clinical Practice Research Datalink. The HR of all-cause mortality comparing (1) SGLT-2is versus DPP-4is in type 2 diabetes and (2) SGLT-2is versus metformin monotherapy among subjects with a diabetes duration of <5 years at cohort entry was calculated using Cox regression. Stratified analyses were performed according to sex and the presence of cardiovascular disease.</p><p><strong>Results: </strong>The cohort consisted of 152 591 new users of antidiabetic drugs, with 15 125 SGLT-2i users, 31 896 DPP-4i users, 15 723 other second-line to third-line antidiabetic drug users and 89 847 first-line antidiabetic drug users at cohort entry. After adjusting for all relevant confounders, SGLT-2i use was associated with a reduced rate of all-cause mortality compared with metformin monotherapy (HR: 0.77, 95% CI: 0.64 to 0.93) or DPP4-i (HR: 0.57, 95% CI: 0.51 to 0.63). This reduced rate of all-cause mortality appeared to be independent of sex and cardiovascular disease.</p><p><strong>Conclusion: </strong>Our findings suggest a reduced risk of all-cause mortality with SGLT-2is compared with DPP-4is or metformin monotherapy in type 2 diabetes among subjects with a diabetes duration of <5 years at cohort entry.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of stress cardiovascular magnetic resonance in patients with ischaemic heart disease and severely reduced left ventricular ejection fraction.","authors":"Ailís Ceara Haney, Janek Salatzki, Andreas Ochs, Thomas Hilbel, Lukas D Weberling, Hauke Hund, Evangelos Giannitsis, Norbert Frey, Henning Steen, Dirk Lossnitzer, Florian André","doi":"10.1136/openhrt-2025-003466","DOIUrl":"https://doi.org/10.1136/openhrt-2025-003466","url":null,"abstract":"<p><strong>Background: </strong>The concept of ischaemia for therapeutic guidance and risk stratification in coronary artery disease has been challenged in recent years. In particular, there is limited understanding of the prognostic value of ischaemia in patients with severely reduced left ventricular ejection fraction (LVEF). The aim of this study was to investigate the prognostic value of stress cardiovascular magnetic resonance (stress CMR) in patients with ischaemic heart disease (IHD) and severely reduced LVEF.</p><p><strong>Methods: </strong>This retrospective study included patients with IHD and an LVEF ≤35% who underwent stress CMR between 2009 and 2022. The primary endpoint was the occurrence of a major adverse cardiovascular event (MACE), including cardiac death, non-fatal myocardial infarction (MI), survived sudden cardiac death and implanted cardioverter defibrillator shock for ventricular fibrillation. The secondary combined endpoint included heart failure hospitalisation, percutaneous coronary intervention, arrhythmia and coronary artery bypass grafting (CABG). All-cause death was also documented.</p><p><strong>Results: </strong>The study population consisted of 362 patients (85.6% men, 70.5 (63.0-78.0) years) with an LVEF of 30.2% (25.2%-33.0%). 245 patients (67.6%) had three vessel disease, 206 patients (57.2%) had a history of MI and 83 patients (22.9%) had a history of CABG. Stress CMR showed ischaemia in 72 (19.9%) patients. Among those, 32 patients (8.8%) underwent early revascularisation. Follow-up was 4.5 (3.0-6.6) years. MACE occurred in 101 patients (27.9%), including 41 cases of cardiac death (11.3%) and 40 cases of MI (11.0%). Ischaemia was not significantly associated with MACE, the combined secondary endpoint, or all-cause death in survival analysis (HR for MACE 1.20, 95% CI 0.74 to 1.95, p=0.4).</p><p><strong>Conclusion: </strong>In a cohort of patients with IHD and severely reduced LVEF, outcome did not differ when stratifying by ischaemia on stress CMR. We found no evidence that ischaemia could identify patients with increased risk for MACE, the combined secondary endpoint or all-cause death.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association analysis of blood pressure with incident risks for thoracic and abdominal aortic aneurysms: an observational study of the UK Biobank cohort.","authors":"Ke Lu, Xiaofei Liu, Yuan Wang, Xun Tang, Pei Gao","doi":"10.1136/openhrt-2025-003240","DOIUrl":"10.1136/openhrt-2025-003240","url":null,"abstract":"<p><strong>Background: </strong>The specific relationship between different blood pressure measures and the risk of aortic aneurysms (AA) remains unclear. Elucidating these associations would be conducive to identifying high-risk individuals and developing more effective screening strategies, potentially reducing AA incidence. This study aimed to investigate the association between various blood pressure measures or subtypes of hypertension and the risk of AA.</p><p><strong>Methods: </strong>Using data from the UK biobank study, we performed multivariable Cox regression analysis to estimate HRs for baseline systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure (PP) with risk of AA. The associations of isolated systolic hypertension, isolated diastolic and combined systolic-diastolic hypertension for AA were also assessed.</p><p><strong>Results: </strong>Our analysis included 397 019 participants without antihypertensive medication at baseline (mean age, 55.4 (SD 8.1) years; 56.6% female). We identified 1782 cases of AA during a median follow-up period of 12 years. The association between SBP and AA was weak (per-SD HR=1.03, 95% CI 0.98 to 1.08). The association between DBP and AA (per-SD HR=1.24, 95% CI 1.15 to 1.33) was significant when DBP reached 80 mm Hg and higher. Lower PP was linearly associated with increasing AA risk (per-SD HR=0.76, 95% CI 0.69 to 0.83). These patterns were consistent when comparing abdominal AA with overall cases. Compared with the normal group, the HRs of isolated systolic hypertension, isolated diastolic hypertension and combined hypertension on AA were 1.01 (95% CI 0.89 to 1.13), 1.67 (95% CI 1.27 to 2.18) and 1.35 (95% CI 1.20 to 1.52), respectively.</p><p><strong>Conclusions: </strong>Elevated DBP and reduced PP, but not SBP, were independently associated with a higher risk of incident AA, highlighting their potential to refine clinical risk stratification.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}